Indian Journal of Pathology and Oncology

. 293-296

Authors: Venkatraman J., K. Bhavani, Jeevitha.

Introduction: Transfusion of blood and its components is a life-saving procedure as even a unit of blood can save a patient in need. Though it is said to be a safe procedure as the blood is tested and processed before its use, risk of transmission of infections like HIV, syphilis, hepatitis B, hepatitis C and malaria are still seen. The present study was done to find out the sero-prevalence of Transfusion transmitted infections among blood donors in one of the tertiary health center in south India. Materials and Method: A retrospective study was conducted from January 2012 to May 2016 in a blood bank of a tertiary care hospital in Puducherry. A total of 8959 blood units which were collected from both voluntary and replacement donors during the study period were included. Complete donor’s demography and screening status for TTI’s were analysed. Results: Present study included a total cases of 8959 blood donors during study period. Out of these, 258(2.87%) were positive for TTIs. Higher seroprevalence of TTI’s were noted in replacement donors and younger age group between 18 to 30 years. Conclusion: Following strict donor criteria, adopting sensitive and advanced screening techniques for TTI’s and conducting various awareness programs, it is possible to bring down the sero-positivity of transfusion transmitted infections.

166-173

Authors: Tanvi Monga, Amarjit Singh Kuka, Navtej Singh.

Malignancy is a major cause of childhood death in developed world and in developing countries like India, paediatric tumours are on the rise. Appropriate management of paediatric tumours requires epidemiological data in different geographical areas. Present study was conducted to classify and find out the histopathological profile of solid tumours of childhood and infancy in 15 years from January 1999 to December 2013. In our study of 168 paediatric tumours, 108 (64.29%) were benign, and 60 (35.71%) were malignant. Maximum incidence of paediatric tumours was seen in the age group of 11-14 years (41.67%) and least in the age group of <1 year (10.71%), with male to female ratio of 1. Amongst the benign tumours, soft tissue tumours were most common (56.48%), with highest incidence of vascular tumours (57.36%). Amongst the malignant tumours, most common were Lymphomas (36.67%) and amongst lymphomas, Hodgkin’s lymphomas were more common (63.64%) than non- Hodgkin’s lymphoma (36.36%).

179-182

Authors: Ankur N. Sarvaiya, Sanjay C. Chauhan.

Background: Hepatitis C has a worldwide prevalence. Various risk factors are blood transfusion, intravenous drug use, chronic hemodialysis etc. Aim: To study the seroprevalence of hepatitis c virus in blood donors, and seropositivity in different high risk population subjects. Compare our results with previous published studies. Materials and Method: Serum of total 1658 subjects were tested with microwell enzyme immunoassay method for detection of antibodies to hepatitis c virus, out of them 1408 were blood donors and 250 were high risk population subjects. Results: Of 1408 normal healthy blood donors, 3 were found seropositive post blood donation. In Comparison, 15 were seropositive for anti-hepatitis c virus antibody (6%) in 250 high risk population subjects. Conclusion: Hepatitis C is currently an emerging disease with years of chronic infection in patients. There is no vaccine for hepatitis C, therefore prevention of HCV infection depends upon reducing the risk of exposure to the virus in health-care settings and in higher risk populations, for example, people who inject drugs, and through sexual contact.

188-192

Authors: Deepa Hatwal, Arvind Kumar, Neha Batra.

Background: Abdominal tuberculosis has become one of the leading cause of morbidity and mortality. It can involve any part of gastrointestinal tract. It is a major public health problem in developing countries. Abdominal tuberculosis still presents a diagnostic challenge as clinical symptoms are nonspecific and mimic various gastrointestinal disorders. Aim: To analyse role of various clinical, histopathological and microbiological findings in confirming the diagnosis of abdominal tuberculosis. Materials and Method: A retrospective study was carried out in a tertiary teaching hospital in Uttarakhand and all cases diagnosed as abdominal tuberculosis were included in the study. All relevant data were collected from medical records. Histopathological examination along with Ziehl-Neelsen staining was done in all the cases to detect acid fast bacilli. Results: Out of the 68 cases of abdominal tuberculosis, intestinal tuberculosis had highest incidence of 45.59%, out of which ileum was the most frequent site .This was followed by peritoneal tuberculosis (33.82%) and nodal tuberculosis (14.71%). Stricture was seen in 41.18% cases. It was seen that in intestinal tuberculosis caseating granuloma had 29.03% positivity for acid fast bacilli while non-caseating had a positivity of 12.90%. In lymph node tuberculosis acid fast positivity was 40% in caseating and 10% in non-caseating granuloma. Adenosine deaminase (ADA) level was raised in 100% cases of ascitic type peritoneal tuberculosis. Majority of the patients were in the age group of 21 to 40 years. Abdominal pain was the most common symptom observed in all cases (100%) of abdominal tuberculosis. Conclusion: Significant variations are seen in the clinical presentation of abdominal tuberculosis. Symptoms are non-specific and diagnostic criterias are limited. Advanced tests are required to diagnose the disease accurately. However, in a low resource setting tissue biopsy is the ultimate tool for diagnosis of abdominal tuberculosis.

199-202

Authors: Shobha SN, Rajashekar YR.

Introduction: Aspiration of serous cavities is a simple and relatively noninvasive technique to achieve the diagnosis of cause of pleural effusion. Cytological examination of pleural fluid obtained by tapping is a simple, inexpensive, diagnostic modality of the cause of pleural effusion and further helps in treatment and follow up of the patients. Not only the infective causes, it also helps in cancer patients either primary or metastatic effusions both in diagnosis and management. Materials and Method: This study on pleural fluid cytology was done on 100 cases in Adichunchanagiri Institute of Medical Sciences B G Nagar for a period of 2 years. Relevant and available clinical information regarding age, sex, symptoms and accompanying signs were obtained from the patients. Pleural fluid was analysed for gross appearances and cytological analysis for cell count, cell type and malignant cells. Results: 100 samples of pleural fluid were received. Incidence of pleural effusion was more in males compared to females with a male to female ratio of 1.6:1. In the benign effusions, various clinical conditions noted were Pulmonary tuberculosis, Pneumonia, and anemia with hypoproteinemia, CCF, and Pulmonary infarction. Exudative effusions were more (84%) compared to transudative effusions (16%). Out of 100 samples received clinical diagnosis of malignant effusions was made in 10 cases and 3 cases which were diagnosed as tuberculous effusion turned out to be malignant effusion by cytology. Conclusion: Pleural fluid cytology is one of the easy, inexpensive mode of diagnosis for the cause of pleural effusion, which also helps in the treatment and management of patients. It can be done in any rural set up with basic facilities where sophisticated techniques are not available.

207-212

Authors: Hemavathi Reddy, Anirudha V. Kushtagi.

Background: Platelet transfusion is one of the most crucial therapeutic approaches in Medicine. In addition to their important function in hemostasis, platelet’s role in inflammation has become more evident. Also they have severe and fatal adverse reactions also. Aim: The aim of the study was to determine the number of platelet transfusions that was done during the study period, to study the indications for the transfusions and evaluate its efficacy. Materials and Method: A total of 138 thrombocytopenic patients who received platelet transfusions were evaluated during a one-year study period from Jan 2015 to Dec 2015 at KIMS Koppal, General hospital with attached blood bank. Conditions associated with the thrombocytopenia were studied and categorized. Pre and post-transfusion platelet counts were done and 24-hour corrected count increment (CCI) was calculated to check the efficacy of transfusion. Results: Majority of the platelet recipients were transfused prophylactically when their platelet counts were >20000/μL. The most common category of diagnosis among these patients was infectious diseases. Conclusion: Appropriate component therapy should be actively endorsed as it ensures optimum utilization of a scarce resource in a populous country like India. Platelet transfusion must be guided by population of patients under consideration, the clinical conditions of the patients and perhaps even the resources of the transfusing facility and its ability to respond rapidly to patients transfusion needs.

218-220

Authors: Mamatha K., Arakeri SU.

Introduction: Lymphadenopathy is the commonest clinical presentation encountered in outpatient as well as in inpatient departments, irrespective of age.(1) It is one of the common clinical presentation in both benign and malignant diseases.(2) Differential diagnoses include reactive hyperplasia/inflammatory conditions, granulomatous disorders and malignancy. Cervical group of lymph nodes are easily accessible for FNAC. Because of the accessibility cervical group of lymph nodes are more commonly subjected for FNAC.(6) Hence cytological study of these lymphnodes is very important first line of investigation in distinguishing between reactive hyperplasia and malignancy. Methods and Material: Patients presented with palpable cervical lymphadenopathy referred for cytological evaluation were included. Thorough examination of the patients was done and also detailed clinical history was taken. Standard FNAC procedure was performed; multiple smears were prepared and analyzed. Results: Total number of cases was 220. Out of which, 162 cases were benign/ infectious and 58 were malignant. Most of the cases were in the age group of 20-39years (32.7%)Reactive lymphadenitis was the commonest diagnosis on cytology constituting to 41.4% followed by malignant cases (26.3 %), granulomatous lymphadenitis (17.7%), suppurative lymphadenitis (10%) and necrotizing lymphadenitis (3.6%). Out of total 58 malignant cases, 51 (87.9%) cases were metastatic lesions, 4 cases were lymphoma and in 3 cases differential diagnosis of lymphoma/ metastatic poorly differentiated carcinoma was considered. Squamous cell carcinoma (67.2%) was the most common morphological type diagnosed on cytology in metastatic lymph nodes, followed by adenocarcinoma. Conclusion: FNAC is a cost effective, quick and reliable, simple tool in diagnosing patients presenting with cervical lymphadenopathy. FNAC serves as a rapid tool for the diagnosis of common and treatable causes of cervical lymphadenopathy. It is also a good sensitive first line method in patients with suspected malignant cervical lymphadenopathy.

227-231

Authors: Priyadarshini Devendrappa, Harish Sadula Govinda Reddy.

Introduction: Hashimoto's thyroiditis is recognized as the next most common thyroid lesion after goiter, diagnosed on fine needle aspiration cytology. It is also considered as the foremost cause of hypothyroidism. Fine needle aspiration cytology is notably perceptive in diagnosing Hashimoto’s thyroiditis with a striking diagnostic preciseness. Our analysis is to scrutinize the cytomorphological diversity of Hashimoto’s thyroiditis. Materials and Method: This study includes 56 patients presented with a solitary thyroid nodule and few cases with diffuse thyroid enlargement and those cases, with cytomorphological features favoring Hashimoto’s thyroiditis. Few cases were confirmed by histopathology following surgery and reported as Hashimoto's thyroiditis and immunological results were correlated whenever available. Results: The majority of the patients in our study were females in their middle age group. In the present study lymphoid aggregates, lymphocytic infiltration amidst follicular epithelial cells and Hurthle cell change were the main highlights along with other cells like eosinophils, epithelioid cells, Plasma cells and multinucleated giant cells seen in few cases. The antibody profile was available in only 60% of the cases of which 72.72% showed evidence of raised anti-thyroid peroxidase antibody titers. The histopathological correlation was obtained only 12.5% cases. Conclusion: Hashimoto’s thyroiditis is considered a disease of middle age with female predominance, clinical history and immunological profile alone is not sufficient in diagnosing Hashimoto’s thyroiditis. FNAC plays a symbolic portrayal in the diagnosis of thyroid lesions due to its ease and reasonable price. It can precisely diagnose Hashimoto's thyroiditis in utmost patients.

237-241

Authors: Ruchi Sinha, Hema Kini, Radha R. Pai, Kaushalya K. Sahu, Aarthi Rau.

Introduction: Fibroadenoma and phyllodes tumor are fibroepithelial neoplasms of the breast composed of proliferating mammary epithelial and stromal tissues.It is very rare for infiltrating ductal carcinoma to arise within or be associated with a phyllodes tumor or a fibroadenoma. Methods and Material: Over a period of ten years, all the breast carcinoma cases from the departmental archives were reviewed. Results: Nine cases of synchronous fibroepithelial tumors with infiltrating carcinoma of the ipsilateral breast were reported. In four cases, the carcinoma was seen infiltrating the benign tumor- one a phyllodes tumor and the other three fibroadenomas. In rest of the five cases the tumors were independent of each other. Conclusion: The occurrence of a carcinoma in a fibroepithelial neoplasm, however rare, necessiciates a thorough histopathological examination of all breast lumps.

247-253

Authors: Madhu Chaturvedi, Sangita Margam, Shweta Azad.

Background: Abnormal uterine bleeding (AUB) is one of the most common debilitating menstrual problems and has remained one of the most frequent indications for hysterectomy in developing countries. The problem is common worldwide but causes may vary from one region to another. In about 25% of the patients, the abnormal uterine bleeding is the result of a well-defined organic abnormality. Materials and Method: It was a five year study conducted at a tertiary care hospital, Mumbai. Total of 804 Women who underwent surgical resections and biopsies with complaints of AUB were included in the study and histopathological spectrum of structural pathology was determined. Results: Most common age group affected was 36-45 years. Uterine corpus was common site of pathology (80.2%), followed by cervix (17.4%) Isolated pathology was found in 88.9% cases while multiple pathology in 10.1% cases. Benign pathology formed largest group (82.34%), commonest being leiomyoma (71.6%). Malignancy seen in 14.8% cases, most common malignancy being squamous cell carcinoma (72.72%). Menorrhagia was commonest presentation (64.6%), followed by postmenopausal bleeding (20%) & polymenorrhagia (14.6%). In postmenopausal age group, malignancy was (46.3%) more as compared to age <40 years (8.7%). Rare cases presenting as AUB were encountered viz. serous cystadenoma, mature cystic teratoma and serous cystadenocarcinoma of ovary, malignant mixed mullerian tumor of uterus, metastasis to uterine corpus, and small round cell tumor of cervix. Conclusion: Frequency of benign endometrial pathology as underlying organic cause of AUB is quite high. However, histopathological spectrum in patients with AUB is quite variable with respect to age with increased chances of detecting malignancy in elder females. Therefore Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignancy.

260-262

Authors: Shwetha J.H., Ashoka A., Shashikala P..

Introduction: Anemia can negatively affect cognitive development, school performance, physical growth and immunity of the children if not treated during infancy. Objectives: To determine the pattern of anemia among 6 months – 12 months infants. Materials and Method: This prospective hospital based study was conducted for a year among the infants aged 6-12months admitted to tertiary care hospital in Davangere. All those who were hospitalized for any other illness but found to have anemia on routine blood investigations were included and complete haemogram was done to determine the type of anemia. Data was entered in excel sheet and analyzed using SPSS- 20 software. Results: In the present study, 211 infants were anemic, mean age was 8.6 ± 2.4months, majority were females (56.9%), more than half of them had presented with respiratory tract infections and acute gastroenteritis (64%). Mean hemoglobin was 8.54±1.09g/dl. Majority of them had moderate anemia (83%) and microcytic hypochromic anemia was the most common presentation (45%). Conclusion: To conclude, the Prevalence of anemia was 66% in the present study with microcytic hypochromic anemia being the major cause (44.8%) suggesting iron deficiency as the major culprit for nutritional anemia seen in infants.

266-272

Authors: M. Sridevi, P. Karkuzhali.

Introduction: Testicular Fine needle aspiration cytology (FNAC) is Simple and minimally traumatic procedure with less number of complications at the same time more sites could be aspirated safely. As well as FNAC could give better morphological details of different stages of spermatogenesis. Materials and Method: This study was done in 36 infertile men for a one year period to evaluate the cytological features of testicular FNAC and correlate with histological diagnosis, and to correlate various cell indices in different categories of cytological diagnosis. Results: In the present study, in Cytology, the common diagnosis was found to be Maturation arrest with a corresponding Johnson’s score of 3 to 7 was found to be the most frequent cause of male infertility. The correlation between the FNAC and biopsy was 91.9%. Sertoli cell index was found to be increased in hypospermatogenesis. Conclusion: The overall accuracy of FNAC in this study was found to be 86% and well correlated with histological diagnosis. Hence testicular FNAC can be used for the diagnosis of male infertility.

278-281

Authors: Suba G., Jayaprakash H.T., Shradha A..

Background: Lymphnode is one of the commonest site for neoplastic and non-neoplastic diseases. This study was undertaken to analyse the patterns of lesions seen in peripheral lymphadenopathy cases. Materials and Method: This retrospective study of 103 cases of lymphnode biopsies was carried out in the department of pathology for a period of 3 years. Relevant patient data were retrieved from the file. Slides were reviewed thoroughly and special stains were applied wherever necessary. Results: Out of 103 cases, 88 (85.4%) were non-neoplastic lesions and 15 (14.6%) were neoplastic lesions. The most commonly biopsied group was cervical nodes. Tuberculosis was the most common condition 44 cases (42.7%) followed by reactive hyperplasia 41 cases (39.8%). Of the 15 cases (14.6%) of malignancy, 10 (9.7%) were metastatic deposits and 5 (4.9%) were lymphomas. Conclusion: Tuberculosis is the leading cause of lymphadenopathy and young females are commonly affected. Histopathology is the gold standard in confirming the diagnosis of lymphnode lesions.

297-300

Authors: Vikram Narang, Amit Dhiman, Bhavna Garg, Neena Sood, Harsimran Kaur.

Acute leukemia is a heterogenous group of disorders, require multidiscplinary approach for diagnosis and prognostication. Immmunophenotyping has emerged as important tool in diagnosis of hematolymphoid malignancies. Since, Punjab is emerging as cancer capital of India, with leukemia cases on the rise. The diagnostic modalities like flow cytometry need to be popularized and more medical fraternity is required to be familiar with this technique. Therefore we hereby present study from the state of Punjab focussing on leukemia patterns diagnosed by flow cytometry.

308-312

Authors: Vandana Patel, Piyush Solanki, Harshid Patel.

Introduction: Cervical cancer is one of the most common cancers in women worldwide. In India, cervical cancer is the most common woman-related cancer, followed by breast cancer. 80% of the new cervical cancer cases occur in developing countries, like India, which reports approximately one fourth of the world's cases of cervical cancer each year. Objective: The primary objective is to find out the prevalence of awareness amongst women living in rural and urban areas, about the utility of PAP smear in early diagnosis of cervical cancer. Materials and Method: This cross sectional study includes 200 women attending the OPD of Gynecology Department of Government Medical College, Bhavnagar Gujarat from April 2015 to May 2016 of age group of 15 to 60 yrs. Among them 100 women were from rural area and 100 were from urban area. Written consent was taken from each participant, after explaining the aims and objectives of the study. Data was collected using a questionnaire including demographic characteristics, knowledge about cervical cancer and knowledge about PAP smear screening and completed by an interview with these participants. Result: This study has shown that women in our region lack knowledge of cervical cancer and its prevention by early detection by Pap smear both in the rural as well as the urban areas. This study clearly conveys the message that the rural women's educational status need to be strengthened at all levels. Conclusion: In conclusion, our results show that there was inadequate knowledge and practice among certain women groups, especially those above 30 years old, married at young age, and those with low education level. Some women also had a positive attitude, although they needed to have reassurances that could reduce the barriers. A well-organized cervical cancer screening programme providing the Pap-smear test through primary health care services is recommended: this should include raising awareness of women regarding risk factors, and overcoming barriers to having the test such as fear and embarrassment.

318-323

Authors: Shanmuga Priya S., Rajalakshmi V., Veena Bheeman.

Introduction: Breast cancer is the most commonly occurring cancer in females and leading cause of cancer related deaths worldwide. The analysis of gene expression data have suggested that breast carcinoma can be divided into molecular subtypes which have distinct clinical features, different prognosis and clinical outcome. Claudins are members of a large family of tight junction proteins that regulate cell adhesion. Currently there are 40 claudins that are variably expressed in several cancers. Only few studies have examined their expression in breast carcinomas. Recently subtype of claudin with low expression has been described that has a prognostic and predictive indication in relation to response following neoadjuvant chemotherapy. Aim: The aim of this study was to classify breast tumors into the molecular patterns based on the expression of estrogen receptor, progesterone receptor and her-2 neu and to evaluate the expression of claudin, ki-67 and p-53 in invasive breast carcinoma. Pathological response following neoadjuvant chemotherapy was assessed in different molecular patterns of invasive breast carcinomas correlating with expression of claudins. Materials and Method: A retrospective analysis of 100 breast carcinomas immunostained with ER, PR and her-2-neu were performed and tumors were subtyped into molecular patterns. Immunostaining with ki-67 and p-53 was done in 43 cases to assess the pathological response to neoadjuvant chemotherapy. Claudin 1, 3, 4, and 7 was tested in 43 cases by RT-PCR method. Results: Of 100 cases of invasive breast carcinomas diagnosed and immunostained during the 5-year period from 2012-2016, basal-cell type accounts to 20 cases, followed by her-2 enriched type (17 cases), luminal -A (47 cases) and luminal-B (16 cases). Claudin was expressed in luminal A (44.2%), luminal B (26%), basal (16.3%) and her-2 enriched (14%) subtype. Incidence of claudin low was seen in 14% of T2-4 lesions, 7% nodal metastasis and 9.3% of high grade tumors. Pathological response was better for basal-like type when compared to other subtypes.Ki-67 expression was high among triple negative tumors when compared to non-triple negative tumors. Pathological response was good in basal-like subtype when p-53 was expressed. Conclusion: The histopathological examination of the tumor helps in assessing the response following neoadjuvant chemotherapy and can be correlated with expression of claudin, ki-67 and p-53.Claudin-low subtype can be seen in triple negative, luminal A& B and her-2 enriched type. More number of cases need to be studied in future to assess the response rate in claudin –low tumors as this has direct impact on current therapeutic strategies and follow-up is mandatory to look for recurrences.

328-332

Authors: Sanjaykumar C. Chauhan, Ankur N. Sarvaiya.

Introduction: Benign and malignant lesions of prostate are some of the commonest problem of elderly men age group. Prostate specific antigen level, histopathological examination, and digital rectal examination are considered three most important evaluation criteria. Objective: To study clinical and histopathologic spectrum of prostatic lesions and compare prostate specific antigen levels in various non-neoplastic, benign and malignant lesions of prostate. Materials and Method: Study was performed prospectively and retrospectively from January 2013 to December 2016 in the department of Pathology in the tertiary care centre in North Gujarat area over the span of 3 years. Histopathologically Gleason system scoring was analyzed. Prostate specific antigen value was noted in each case. Results: Mean age of all 140 cases was 65.5± 10.7years, of all BPH cases it was 66.07 years, and 72 years of adenocarcinoma cases. Frequency of urination was most common presenting symptom (42 cases - 30%) followed by difficulty in voiding (38 cases – 27.14%). The commonest histopathological diagnosis was benign prostatic hyperplasia - 90 cases (64.28%), next is adenocarcinoma -38 cases (27.14%). The commonest Gleason system score in prostatic adenocarcinoma cases was score 7. Benign prostatic hyperplasia and Prostate carcinoma cases had mean prostate specific antigen value of 5.05 ± 3.15 ng per ml and 59.65 ±38.65 ng per ml respectively. Conclusion: Prostate specific antigen value should be measured periodically in elderly men as a screening tool. Each higher value must be followed by histopathological evaluation of prostate biopsy for exact nature of disease confirmation.

336-338

Authors: Sunitha S., Arundhathi S., Anil Malleshi Betigeri.

Mature cystic teratoma (MCT) is commonest germ cell tumor of ovary. In 1-2% of MCTs malignant transformation is known to occur. Most of the malignancies originating from MCTs are squamous cell carcinomas and adenocarcinomas of intestinal type are exceptionally rare. Nine cases have been reported till date and we are presenting this case because of its rarity and unusual presentation. We are presenting a case of 33 year old female with abdominal mass and raised CEA and CA-125. Histopathology and immunohistochemistry confirmed the diagnosis as adenocarcinoma of intestinal type arising in mature cystic teratoma.

344-347

Authors: Purwa Patil, Varsha Bhatia, Vaishali Walke, Divyaja Sondankar.

Orbital rhabdomyosarcoma (RMS) is the most common orbital malignancy of childhood. It is a highly malignant tumour and is one of the few life threatening diseases, if its diagnosis is delayed. Among the entire group of extraconal intraorbital tumours RMS poses a significant challenge for the pathologist and oncologist in terms of its diagnosis and treatment. This case report highlights the general overview of primary orbital RMS, its histopathological and immunohistochemical features and management.

351-353

Authors: Varsha Pandey, V. Sudarshan, Shiv Chandraker, K. S. Chandrakar.

Primary angiosarcoma of the spleen is a very rare malignant neoplasm. It comprises less than 1% of all splenic sarcomas. It may present with non-traumatic spontaneous rupture of the spleen and lethal hemorrhage. It is difficult to diagnose clinically and has a variable morphological spectrum. It is a highly aggressive malignant tumor having poor prognosis. It is usually found in adults above 40 years of age. A 22 year old female presented with abdominal pain and mass of four month duration. Physical examination revealed splenomegaly and diffuse tenderness all over the abdomen. Following computed tomography scan a possible clinical diagnosis of giant cavernous hamangioma of the spleen was made. Histopathology following splenectomy revealed angiosarcoma. We report this rare case along with review of literature.