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SYSTEMIC LUPUS ERYTHEEMATOSUS WITH MULTIPLE CALCIFIED FIBROUS NODULES OF THE SPLEEN

An autopsy case of systemic lupus erythematosus (SLE) in a 39‐year‐old woman with peculiar multiple splenic nodules is reported. Multiple calcific nodular shadows were incidentally found in the left hypochondrial region on chest and abdominal X‐ray films taken at admission. The patient died of chronic heart failure due to massive pericardial effusion as one of the manifestations of SLE with 2 and a half years' clinical course. Lupus nephritis and terminal miliary tuberculosis were the other conspicuous autopsy findings. The splenic nodules were almost evenly distributed on each cut‐surface of the spleen at the density of about 5/cm2. Each nodule was spherical in shape and 1 to 3 mm in diameter. Most of the nodules were calcified in variable degrees. Semi‐serial sectionings and reconstruction procedure of the nodules disclosed that they were formed around the central or penicillary arteries and had a close relation to so called “onion‐skin lesion” of the spleen in SLE. The true nature, pathogenesis, and relation of the nodules to SLE are discussed.