Sclerosing angiomatoid nodular transformation of the spleen: a new entity or a new name?

Agrawal, Manindra; Uppin, Shantveer G; Bh, Srinivas; Suppin, Megha; Bheerappa, Nagari; Challa, Sundaram

doi:10.5146/tjpath.2013.01219

Cited by 12 publications

(15 citation statements)

References 8 publications

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“…These lesions are usually detected by radiological methods, such as computed tomography (CT) and magnetic resonance imaging (MRI), during the diagnostic workup of patients with chronic abdominal pain; however, definitive diagnosis requires histopathologic confirmation. 2 Splenectomy is the treatment of choice in symptomatic patients. 3 Herein, we report a rare case of SANT in a young adult male with long-lasting abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain

Ataş¹,

Buluş²,

Akkurt³

2017

Euroasian Journal of Hepato-Gastroenterology

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Sclerosing angiomatoid nodular transformation (SANT) is a rare and benign lesion arising from the red pulp of the spleen, with an unknown etiopathogenesis. These tumors are usually asymptomatic or cause nonspecific abdominal pain. Most SANTs are found incidentally on radiographic examination, or during surgery for an unrelated condition. Therefore, high clinical suspicion is of great importance for the diagnosis. Splenectomy provides complete cure, and no recurrence and/or malignant transformation was reported to date. In this study, a rare case of SANT was reported in a young adult male, and was discussed with the relevant literature.How to cite this article: Atas H, Bulus H, Akkurt G. Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain. Euroasian J Hepato-Gastroenterol 2017;7(1):89-91.

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Section: Introductionmentioning

confidence: 99%

Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain

Ataş¹,

Buluş²,

Akkurt³

2017

Euroasian Journal of Hepato-Gastroenterology

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“…The most recent studies show that SANT results from sclerotic changes accompanied by IgG4-related inflammatory diseases [8]. SANT can also be accompanied by malignant and hematologic diseases, such as polyclonal gammopathy and myelodysplastic syndrome [9].…”

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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“…However, this matter could be resolved based on the speculated developmental mechanism of SANT. The combination of stagnant splenic circulation due to passive congestion and local metabolic changes as a result of anoxia are considered to initiate the formation of angiomatoid nodules, which result in the proliferative transformation of the red pulp to form SANT . The reactive nature of SANT distinguishes it from CCH.…”

Section: Discussionmentioning

confidence: 99%

“…The combination of stagnant splenic circulation due to passive congestion and local metabolic changes as a result of anoxia are considered to initiate the formation of angiomatoid nodules, which result in the proliferative transformation of the red pulp to form SANT. 16 The reactive nature of SANT distinguishes it from CCH. Interestingly, several recent reports have suggested that SANT might have a spectrum with IgG4-related sclerosing disease based on the predominance of IgG4-expressing plasma cells observed in its stroma.…”

Section: Discussionmentioning

confidence: 99%

A case of cord capillary hemangioma of the spleen: A recently proven true neoplasm

Tajima

Koda

2015

Pathology International

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Cord capillary hemangioma (CCH) of the spleen is an extremely rare lesion. Once classified under splenic hamartoma, CCH is now differentiated from hamartoma, as its clonality has recently been proven. Herein, we present the case of an incidentally found CCH, measuring 6 × 5.5 × 5 cm, in a 45-year-old man. He underwent splenectomy and has been recurrence-free for 8 years. Macroscopically, the cut surface of the mass showed a central stellate scar with peripheral interspersed reddish areas of variable sizes and intervening fibrous bands. Microscopically, the mass was well demarcated from the splenic tissue. The macroscopic reddish areas were found to correspond to nodules of various sizes, which were predominantly composed of CD34-expressing capillaries without the presence of CD8-expressing sinuses. The relative proportion of these two types of vessels distinguishes CCH from sclerosing angiomatoid nodular transformation (SANT), as SANT shows the apparent presence of CD8-expressing sinuses. In longstanding cases of SANT, sinuses might become ambiguous and the differences between CCH and SANT might become subtle. Nonetheless, immunohistochemistry should be performed when these conditions are suspected, since accurate distinction is usually achieved as a result.

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Sclerosing angiomatoid nodular transformation of the spleen: a new entity or a new name?

Cited by 12 publications

References 8 publications

Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain

Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain

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

A case of cord capillary hemangioma of the spleen: A recently proven true neoplasm

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