IntroductionSclerosing Angiomatoid Nodular Transformation of the spleen is a benign vascular lesion with no known etiology.Presentation of CaseWe report a new case in a symptomatic twenty-one-year old female with thrombocytopenia and a hypervascular splenic mass discovered on ultrasound. Two MRIs were performed prior to hand-assisted laparoscopic splenectomy. The specimen was sent for histopathologic analysis with confirmation of final diagnosis from an outside facility.DiscussionSclerosing Angiomatoid Nodular Transformation of the spleen is most often discovered incidentally as a solitary splenic mass. The presence of a spoke-wheel pattern should alert the radiologist to this as a possibility.ConclusionUltrasound and MR imaging findings can be used to accurately diagnose cases of splenic Sclerosing Angiomatoid Nodular Transformation. Susceptibility artifact within the lesion may be directly related to the amount of iron deposition.

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A 71-year-old man with history of gastroesophageal reflux disease, chronic sinusitis, arthritis, hypothyroidism, and anemia of chronic disease initially sought treatment with a recurrent left pleural effusion along with other abnormal lung findings on chest CT scan. Before his referral, he was being managed for 3 years at his local hospital for waxing and waning fevers, fatigue, productive cough, chills, and night sweats. He did not report any hemoptysis or chest pain, but reported weight loss of 13 kgs in 15 months. During those 3 years, he was treated with multiple courses of antibiotics and steroids with temporary relief of symptoms. At that time, his chronic sinusitis was suspected to be the cause of his symptoms and he underwent balloon sinuplasty. He was receiving daily sublingual immunotherapy for inhaled respiratory allergens for the previous year after showing positive test results for 17 inhaled allergens. The patient had no other known immunologic workup before our evaluation.