Percutaneous ultrasound-guided coaxial core needle biopsy for the diagnosis of multiple splenic lesions: A case report

Figure 1 Ultrasonography images of the patient. A: Conventional grayscale ultrasound (US) showed multiple hypoechoic nodules and masses in the spleen; B: There were no blood flow signals in the splenic lesions on Color Doppler US; C: Arterial phase imaging on contrast-enhanced US; D: Venous phase imaging on contrast-enhanced US.

Figure 2 Contrast-enhanced computed tomography images of the patient. Contrast-enhanced computed tomography revealed an enlarged spleen, with multiple irregular nodular and patchy low density shadows, the largest measuring approximately 1.7 cm × 1.7 cm.

Figure 3 Images of the puncture procedure. A: A 18G coaxial needle (arrow) was applied under real-time ultrasound guidance; B: A muddy mixture(arrowheads) of gelfoam and saline was injected into the coaxial needle sheath to prevent hemorrhage at the end of procedure.

Figure 4 Histopathological findings by hematoxylin-eosin staining (40 ×). Granulomas were noted in focal areas, accompanied by peripheral lymphoid hyperplasia involving infiltration of neutrophils, monocytes, and plasma cells.