SCLEROSING ANGIOMATOID NODULAR TRANSFORMATION OF THE SPLEEN - A REPORT OF TWO CASES AND REVIEW OF LITERATURE

EL DEEB N.M.F.¹, HASSAB H.A.², ASAL M.F.³, HASSAB T.H.^4
1Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
²Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
³Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
⁴Department of Surgery, Medical Research Institute, Alexandria, Egypt.

Received : 12-11-2013     Accepted : 27-02-2014     Published : 24-03-2014
Volume : 3     Issue : 1       Pages : 49 - 53
J Pathol Res 3.1 (2014):49-53

Conflict of Interest : None declared

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign, proliferative vascular lesion affecting the spleen. Only a few cases have been reported to date. In this study, two cases of SANT are presented with their clinical and pathological features, and review of the related literature. The first case is a 34-year-old woman who presented with right hypochondrial pain. She gave a history of mild left hypochondrial discomfort that started 2 years prior to presentation. Computed tomography (CT) showed gall stones together with a 9 cm-sized solitary well-defined hypodense splenic mass. She underwent splenectomy and cholecystectomy. The second case is a 22-year-old man who was evaluated for a 6-months history of left hypochondrial pain. An 8 cm-sized solitary splenic mass was detected on CT scan; and contrast-enhanced magnetic resonance imaging (MRI) revealed a spoke-wheel pattern of enhancement. Splenectomy was performed. In both cases, the spleen showed grossly a well-circumscribed solid mass with a multinodular hemorrhagic cut surface. Microscopically, the mass consisted of multiple angiomatoid nodules surrounded by collagen bundles with a lymphoplasmacytic infiltrate. Immunohistochemically, CD31, CD34 and CD8 were detected in the endothelial cells of the angiomatoid nodules. Smooth muscle actin and CD68 expression was noted as well, but there was no reactivity for CD21. SANT has an excellent prognosis with splenectomy being curative.