Gross and Microscopic Case Study on Splenic Capsular Pathology in a Cadaver with Congestive Heart Failure: A Postmortem Evaluation

Splenic pathology in the setting of systemic congestion is often characterized by parenchymal enlargement and vascular engorgement. In addition to these diffuse hemodynamic changes, discrete splenic lesions may be encountered, raising important diagnostic considerations. Such lesions range in clinical significance from incidental, benign nodules to processes that are infectious or malignant in nature. However, isolated capsular parenchymal abnormalities are less commonly described. We report a cadaveric case of a donor with documented cardiac failure and multiorgan enlargement, including cardiomegaly, hepatomegaly, and renomegaly. Gross examination of the spleen revealed discrete nodular irregularities confined to the capsular surface without extending into the splenic parenchyma. Various pathologies were explored; ultimately fibrinous perisplenitis was most consistent with our findings. Accurate characterization of the pathology at hand is needed to guide management, preventing any undesirable interventions.