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- Title
A case of sclerosing angiomatoid nodular transformation of the spleen.
- Authors
Miao Lu; Perry, Kyle
- Abstract
Background: Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiology or pathogenesis. Most cases are found incidentally on imaging where it can mimic other lesions. Here we report a case of SANT and review the pertinent literature associated with this uncommon entity. Case report: A 42-year-old male presented with vague left abdominal tenderness. A CT scan showed a solitary mass (3.8 cm) in the spleen, which slightly increased in size over a 4-month period. The radiologic findings raised a suspicion for malignant entities, such as lymphoma, angiosarcoma or metastatic carcinoma. The patient underwent a splenectomy, and grossly, the spleen contained a solitary, circumscribed and lobulated tan-grey lesion with central fibrosis. On microscopic examination, the lesion was composed of multiple coalescing vascular nodules with hyalinizing sclerosis and associated chronic inflammation. Scattered areas of hemosiderin deposition were noted. CD8 and CD31 highlighted residual sinusoid areas. CD34, ERG and CD31 highlighted scattered capillaries of the lesion. Overall, the findings were consistent with sclerosing angiomatoid nodular transformation. Conclusion: Although SANT demonstrates distinct histopathological changes, the differential diagnosis includes other benign and malignant vascular lesions of the spleen, including littoral cell angioma, hemangiomas, lymphangioma, splenic hamartoma, hemangioendothelioma and angiosarcoma. The exact nature of these lesions is still unknown, though some have suggested this could represent reactive changes associated with inflammation. This is a benign entity and splenectomy is considered curative.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p29
- ISSN
1918-915X
- Publication type
Article