Case report and magnetic resonance images of sclerosing angiomatoid nodular transformation (SANT) of the spleen

Chikkappa, Maruthesh Gowda; Morrison, Charles; Lowe, Andrew; Antrim, Ralph; Swirsky, D; Gokhale, Jay

doi:10.1136/bcr.07.2009.2131

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…However, on T2-weighted images, the lesion appeared as a spoke-and-wheel pattern, which was similar to the pattern obtained by multiphase imaging with CT. Subsequent studies ( 1 , 12 – 14 ) have described the MRI features of SANT, and numerous investigators have suggested that the spoke-and-wheel pattern from MRI and multiphase CT imaging may be useful for the diagnosis of SANT.…”

Section: Discussionmentioning

confidence: 99%

Sclerosing angiomatoid nodular transformation of the spleen: A case report and literature review

Wang

Liu

et al. 2016

Oncology Letters

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Sclerosing angiomatoid nodular transformation (SANT) is a rare benign splenic vascular lesion. Since it was first defined in 2004, a total of 132 cases of SANT have been reported in ~50 studies in the English literature. However, it remains difficult to form a definitive pre-operative differential diagnosis of SANT compared with other splenic tumors or malignant lesions. The present study reports a pathologically proven case of SANT in a 29-year-old man who initially presented with left upper quadrant and back discomfort. The study also provides a review of the current knowledge on the condition, including the clinical profile, imaging features, cytological features, differential diagnosis and treatment of SANT. The most important distinguishing features of SANT are its typical vascular character and lack of other features that are typical of a granuloma. A splenectomy is required and the diagnosis is based on pathological analysis.

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Section: Discussionmentioning

confidence: 99%

Sclerosing angiomatoid nodular transformation of the spleen: A case report and literature review

Wang

Liu

et al. 2016

Oncology Letters

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“…Because the differential diagnosis for a hypodense mass in the spleen includes lymphoma, metastasis, and benign lesions such as hamartoma, diagnostic studies are essential in the management. On computer tomography scans (CT) and MRI, SANT is a hypodense mass [[19], [20], [21]]. Karaosmanoglu et al described MRI appearances on T1-weighted images as “spokes wheel pattern” [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Weinreb et al argue that due to its distinctive nodular pattern, lack of atypia, and unique immunohistochemical profile, that core biopsy can be used to distinguish SANT from other lesions in the differential diagnosis [23]. However, these procedure carries risks of bleeding and needle tract seeding [20]. Therefore, splenectomy may be the preferred modality to rule out malignancy or other pathological processes [24].…”

Section: Discussionmentioning

confidence: 99%

Sclerosing angiomatoid nodular transformation (SANT) of spleen mimicking a splenic abscess: Case report and review of the literature

Capaldi

Fransvea

Ricci

et al. 2019

International Journal of Surgery Case Reports

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Highlights Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized benign, proliferative vascular lesion affecting the spleen. A limited number of cases are described in the worldwide literature. Further case studies are needed to elucidate the mechanism of SANT and its possible various etiologies. In the light of above splenectomy at now is the choice treatment both for diagnosis and treatment. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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“…Macroscopically, on the cross-section of the spleen, the change has a starry aspect. In a large number of reports, the starry shape of SANT has the "spoked wheel" appearance in MDCT and T2weighted MRI images [18,19,20]. However, characteristic and pathognomic radiological findings, which could help unequivocally diagnose SANT, have not been defined yet.…”

Section: Discussionmentioning

confidence: 99%

Sclerosing angiomatoid nodular transformation of the spleen - An uncommon splenic pseudotumorus variant

Grubor¹,

Tadić²,

Micev

et al. 2019

Srp Arh Celok Lek

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Introduction Sclerosing angiomatoid nodular transformation is a benign splenic pseudotumorous multinodular vascular proliferation. In the past, it was usually reported as splenic hamartoma, multinodular hemangioma or splenic hemangioendothelioma. Since it was defined in 2004, a total of 150 cases have been reported. We will present our experience with a 58-year-old female patient who underwent splenectomy due to the tumorous change in the upper pole of the spleen, histopathologically characterized as sclerosing angiomatoid nodular transformation of the spleen. Case outline A 58-year-old women presented with abdominal pain, anemia, elevated C-reactive protein and fibrinogen level. Abdominal ultrasound and MDCT scan found a well-circumscribed, homogeneous, low-density tumor in the upper pole of the spleen. As the nature of the tumorous change could not be accurately determined and malignancy could not be excluded, splenectomy was performed. Histological findings showed multiple similar nodular foci, hardly discernible from splenic parenchyma, angiomatoid nodules surrounded and separated by partly collagenized fibroblastic areas admixed with mononuclear inflammatory infiltrate in various proportions. All findings were characterized as the coexistence of sclerosing angiomatoid nodular transformation of the spleen and splenic inflammatory pseudotumor. Conclusion Splenectomy, laparoscopic or open, is an acceptable therapeutic and at the same time diagnostic method. Considering the important role of the spleen in the immune system, partial splenectomy is also an option, especially in children. However, the coexistence of sclerosing angiomatoid nodular transformation of the spleen and inflammatory pseudotumor indicates a careful treatment decision, given the tendency of inflammatory pseudotumor to relapse, and, rarely, the possibility of malignant transformation.

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Case report and magnetic resonance images of sclerosing angiomatoid nodular transformation (SANT) of the spleen

Cited by 6 publications

References 3 publications

Sclerosing angiomatoid nodular transformation of the spleen: A case report and literature review

Sclerosing angiomatoid nodular transformation of the spleen: A case report and literature review

Sclerosing angiomatoid nodular transformation (SANT) of spleen mimicking a splenic abscess: Case report and review of the literature

Sclerosing angiomatoid nodular transformation of the spleen - An uncommon splenic pseudotumorus variant

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