Melike Ruşen METİN, Şehnaz EVRİMLER, Nurdan ÇAY, Hüseyin ÇETİN

An unusual case of sclerosing angiomatoid nodular transformation: radiological and histopathological analyses

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign primary vascular lesion of the spleen. Its etiology is still debated. Radiological characteristics are less known, although there are some reports regarding histopathological features of SANT. A 21-year-old male patient was admitted to our hospital with fatigue, weight loss, and abdominal pain for 4 months. Physical examination, complete blood count, and biochemical parameters were unremarkable. Dynamic contrast-enhanced computed tomography (CT) of the abdomen was performed. A heterogeneous well-defined hyperdense nodular lesion 3 cm in diameter was detected during the arterial phase. The detected lesion was seen as isodense with the spleen parenchyma during the portal venous and late venous phases. Magnetic resonance imaging (MRI) showed an isointense-hypointense nodular lesion on T1- and T2-weighted images. Intraabdominal LAM or splenomegaly was not detected. Microscopically, it was composed of angiomatoid nodules separated by central stellate fibrous stroma and fibrous septa. The contrast enhancement pattern was described as centrally hypovascular, radially progressive centripetal vascular contrast enhancement, called a spoke-wheel pattern in previously reported cases. We present CT and MRI findings and their correlation with histopathological findings of a case of unusual symptomatic SANT.

Anahtar Kelimeler:

Key words: Computed tomography, magnetic resonance imaging, sclerosing angiomatoid nodular transformation, spleen

An unusual case of sclerosing angiomatoid nodular transformation: radiological and histopathological analyses

Keywords:

Key words: Computed tomography, magnetic resonance imaging, sclerosing angiomatoid nodular transformation, spleen,

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Hashemieh M, Akhlaghpoor S, Azarkeivan A, Azizahari A, Shirkavand A, Sheibani K. Partial radiofrequency ablation of the spleen in thalassemia. Diagn Interv Radiol 2012; 18: 397– 40
Öngören AU, Taylan Özkan A, Demirel AH, Üstün H, Dönmez M. Ectopic intra-abdominal fascioliasis. Turk J Med Sci 2009; 39: 819–823.
Kayaaslan B, Akıncı E, Baştuğ A, Eren SS, Öngürü P, But A, Yetkin MA, Bodur H. Analysis of 161 adult patients with brucellosis. Turk J Med Sci 2013; 43: 187–193.
Thacker C, Korn R, Millstine J, Harvin H, Van Lier Ribbink JA, Gotway MB. Sclerosing angiomatoid nodular transformation of the spleen: CT, MR, PET, and 99mTc-sulfur colloid SPECT CT findings with gross and histopathological correlation. Abdom Imaging 2010; 35: 683–689.
Karaosmanoglu DA, Karcaaltincaba M, Akata D. CT and MRI findings of sclerosing angiomatoid nodular transformation of the spleen: spoke wheel pattern. Korean J Radiol 2008; 9 Suppl: S52–S55.
Awamleh AA, Perez-Ordoñez B. Sclerosing angiomatoid nodular transformation of the spleen. Arch Pathol Lab Med 2007; 131: 974–978.
Martel M, Cheuk W, Lombardi L, Lifschitz-Mercer B, Chan JK, Rosai J. Sclerosing angiomatoid nodular transformation (SANT): report of 25 cases of a distinctive benign splenic lesion. Am J Surg Pathol 2004; 28: 1268–1279.
Hekimoğlu B, Şimşir BD, Altunkan MŞ. Incidental findings on electron beam tomography angiography in hypertensive patients. Turk J Med Sci 2013; 43: 529–536.
Karakaş HM, Tunçbilek N, Ökten ÖÖ. Splenic abnormalities: an overview on sectional images. Diagn Intervent Radiol 2005; 11: 152–158.
Yazici P, Aydin U, Ersin S, Kaplan H. Hamartoma-A rare benign tumor of the spleen: a report of four cases. EAJM 2008; 40: 48–51.
Hasiloglu ZI, Metin DY, Ozbayrak M, Havan N. Locally invasive primary splenic angiosarcoma. EAJM 2010; 42: 160– 1
Li L, Fisher DA, Stanek AE. Sclerosing angiomatoid nodular transformation (SANT) of the spleen: addition of a case with focal CD68 staining and distinctive CT features. Am J Surg Pathol 2005; 29: 839–841.
Kim HJ, Kim KW, Yu ES, Byun JH, Lee SS, Kim JH, Lee JS. Sclerosing angiomatoid nodular transformation of the spleen: clinical and radiologic characteristics. Acta Radiol 2012; 53: 701–706.
Lee JC, Lien HC, Hsiao CH. Coexisting sclerosing angiomatoid nodular transformation of the spleen with multiple calcifying fibrous pseudotumors in a patient. J Formos Med Assoc 2007; 106: 234–239.
Zeeb LM, Johnson JM, Madsen MS, Keating DP. Sclerosing angiomatoid nodular transformation. AJR Am J Roentgenol 2009; 192: 236–238.