LAUSR

often requires a splenectomy for complete histological assessment. Macroscopically, the nodules appear as one or more tan-white, fleshy circumscribed lesions within the spleen and may resemble lymphoma. Splenomegaly often occurs with diffuse lymphoid hyperplasia, but is not seen in localized lymphoid hyperplasia. Microscopic features include localized, well-circumscribed aggregates of lymphoid cells with clusters of secondary follicles which may include a surrounding zone of T cells. The aetiology and pathophysiology of the condition remains unknown, but likely represents a reactive process to some form of antigenic stimulation. This is the first case of localized lymphoid hyperplasia of the spleen identified on surveillance computed tomography and PET scan in a patient undergoing surveillance for a history of colorectal adenocarcinoma. Although surgery was indicated due to concerning imaging features and the inability to exclude metastatic disease, this report highlights the need for a broad set of differential diagnoses when it comes to splenic masses so that patients can be well informed and consented for surgery.