No abstract

Littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen with characteristic histomorphologic features. Only a few descriptions of the radiologic appearance of this tumor have been published, and those descriptions are variable. We report a case of LCA in a 37-year-old man with psoriasis and nonspecific symptoms of weakness, pain and fatigue, normocytic anemia, and thrombocytopenia. The results of abdominal sonography and contrast-enhanced CT correlated: the 2 modalities revealed hepatosplenomegaly and multiple round splenic lesions of similar appearance and size (on sonograms, ill-defined echogenic lesions up to 3.2 cm without acoustic enhancement; on CT scans, hypodense, nonenhancing lesions up to 3.5 cm). Because making a differential diagnosis was difficult and our presumptive diagnosis was hemangioma or lymphoma, splenectomy was performed. Postoperative pathologic examinations confirmed a final diagnosis of LCA. The patient's recovery was uneventful. LCA should be considered when making a differential diagnosis of splenic lesions, and sonography may be more helpful than CT in reaching a diagnosis of LCA.

We report the case of a 9.5-year-old boy who underwent sonographic and radiographic examinations because of knee pain. Two fibrous cortical defects were discovered, in his right femur and left tibia; the femoral lesion was seen more easily on sonography than on radiography. On gray-scale sonography, the lesions were characterized as a scalloped indentation of the cortical surface containing hypoechoic soft tissue. On color Doppler sonography, discrete vessels were found at the periphery and within the substance of the lesions, and on spectral Doppler analysis, low-resistance arterial flow was detected in those vessels. Follow-up examinations performed 10 and 19 months after our initial examination showed signs that the lesions were healing. The diagnosis of fibrous cortical defect was suggested by the gray-scale and Doppler sonographic characteristics and confirmed on radiography. Although radiography is required to document these lesions if found incidentally on sonography, follow-up examinations using only sonography may be feasible.