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

Wang,Tian‑Bao; Hu,Bao‑Guang; Liu,Da‑Wei; Gao,Zhen‑Hua; Shi,Han‑Ping; Dong,Wen‑Guang

doi:10.3892/ol.2016.4720

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

Authors:
- Tian‑Bao Wang
- Bao‑Guang Hu
- Da‑Wei Liu
- Zhen‑Hua Gao
- Han‑Ping Shi
- Wen‑Guang Dong
View Affiliations

Affiliations: Department of Surgery, The First Affiliated Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China, Department of Gastrointestinal Surgery, The Affiliated Hospital, Binzhou Medical College, Binzhou, Shandong 256603, P.R. China, Department of Pathology, The First Affiliated Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China, Department of Radiology, The First Affiliated Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510080, P.R. China
Published online on: June 15, 2016 https://doi.org/10.3892/ol.2016.4720
Pages: 928-932
Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

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.

View Figures

View References

1	Martel M, Cheuk W, Lombardi L, Lifschitz-Mercer B, Chan JK and Rosai J: Sclerosing angiomatoid nodular transformation (SANT): Report of 25 cases of a distinctive benign splenic lesion. Am J Surg Pathol. 28:1268–1279. 2004. View Article : Google Scholar : PubMed/NCBI
2	Falk GA, Nooli NP, Morris-Stiff G, Plesec TP and Rosenblatt S: Sclerosing angiomatoid nodular transformation (SANT) of the spleen: Case report and review of the literature. Int J Surg Case Rep. 3:492–500. 2012. View Article : Google Scholar : PubMed/NCBI
3	Thipphavong S, Duigenan S, Schindera ST, Gee MS and Philips S: Nonneoplastic, benign, and malignant splenic diseases: Cross-sectional imaging findings and rare disease entities. AJR Am J Roentgenol. 203:315–322. 2014. View Article : Google Scholar : PubMed/NCBI
4	Önder S, Kosemehmetoglu K, Himmetoglu Ç, Firat P and Uner A: Sclerosing angiomatoid nodular transformation (SANT) of spleen: A case report describing cytology, histology, immunoprofile and differential diagnosis. Cytopathology. 23:129–132. 2012. View Article : Google Scholar : PubMed/NCBI
5	Diebold J, Le Tourneau A, Marmey B, Prevot S, Müller-Hermelink HK, Sevestre H, Molina T, Billotet C, Gaulard P, Knopf JF, et al: Is sclerosing angiomatoid nodular transformation (SANT) of the splenic red pulp identical to inflammatory pseudotumour? Report of 16 cases. Histopathology. 53:299–310. 2008. View Article : Google Scholar : PubMed/NCBI
6	Agrawal M, Uppin SG, Bh S, Suppin M NB and Challa S: Sclerosing angiomatoid nodular transformation of the spleen: A new entity or a new name? Turk Patoloji Derg. Apr 9–2014.(Epub ahead of print). PubMed/NCBI
7	Pradhan D and Mohanty SK: Sclerosing angiomatoid nodular transformation of the spleen. Arch Pathol Lab Med. 137:1309–1312. 2013. View Article : Google Scholar : PubMed/NCBI
8	Raman SP, Singhi A, Horton KM, Hruban RH and Fishman EK: Sclerosing angiomatoid nodular transformation of the spleen (SANT): Multimodality imaging appearance of five cases with radiology-pathology correlation. Abdom Imaging. 38:827–834. 2013. View Article : Google Scholar : PubMed/NCBI
9	Lewis RB, Lattin GE Jr, Nandedkar M and Aguilera NS: Sclerosing angiomatoid nodular transformation of the spleen: CT and MRI features with pathologic correlation. AJR Am J Roentgenol. 200:W353–W360. 2013. View Article : Google Scholar : PubMed/NCBI
10	Karaosmanoglu DA, Karcaaltincaba M and Akata D: CT and MRI findings of sclerosing angiomatoid nodular transformation of the spleen: Spoke wheel pattern. Korean J Radiol. 9(Suppl): S52–S55. 2008. View Article : Google Scholar : PubMed/NCBI
11	Thacker C, Korn R, Millstine J, Harvin H, Van Lier Ribbink JA and Gotway MB: Sclerosing angiomatoid nodular transformation of the spleen: CT, MR, PET, and ⁹⁹(m)Tc-sulfur colloid SPECT CT findings with gross and histopathological correlation. Abdom Imaging. 35:683–689. 2010. View Article : Google Scholar : PubMed/NCBI
12	Lee D, Wood B, Formby M and Cho T: F-18 FDG-avid sclerosing angiomatoid nodular transformation (SANT) of the spleen: Case study and literature review. Pathology. 39:181–183. 2007. View Article : Google Scholar : PubMed/NCBI
13	Bamboat ZM and Masiakos PT: Sclerosing angiomatoid nodular transformation of the spleen in an adolescent with chronic abdominal pain. J Pediatr Surg. 45:E13–E16. 2010. View Article : Google Scholar : PubMed/NCBI
14	Chikkappa MG, Morrison C, Lowe A, Antrim R, Swirsky DM and Gokhale J: Case report and magnetic resonance images of sclerosing angiomatoid nodular transformation (SANT) of the spleen. BMJ Case Rep. 2009:bcr07.2009.21312009.PubMed/NCBI
15	Cao JY, Zhang H and Wang WP: Ultrasonography of sclerosing angiomatoid nodular transformation in the spleen. World J Gastroenterol. 16:3727–3730. 2010. View Article : Google Scholar : PubMed/NCBI
16	Gutzeit A, Stuckmann G and Dommann-Scherrer C: Sclerosing angiomatoid nodular transformation (SANT) of the spleen: Sonographic finding. J Clin Ultrasound. 37:308–311. 2009. View Article : Google Scholar : PubMed/NCBI
17	Kim HJ, Kim KW, Yu ES, Byun JH, Lee SS, Kim JH and Lee JS: Sclerosing angiomatoid nodular transformation of the spleen: Clinical and radiologic characteristics. Acta Radiol. 53:701–706. 2012. View Article : Google Scholar : PubMed/NCBI
18	Lee M, Caserta M and Tchelepi H: Sclerosing angiomatoid nodular transformation of the spleen. Ultrasound Q. 30:241–243. 2014. View Article : Google Scholar : PubMed/NCBI
19	Watanabe M, Shiozawa K, Ikehara T, Kanayama M, Kikuchi Y, Ishii K, Okubo Y, Shibuya K and Sumino Y: A case of sclerosing angiomatoid nodular transformation of the spleen: Correlations between contrast-enhanced ultrasonography and histopathologic findings. J Clin Ultrasound. 42:103–107. 2014. View Article : Google Scholar : PubMed/NCBI
20	Giovagnoni A, Giorgi C and Goteri G: Tumours of the spleen. Cancer Imaging. 5:73–77. 2005. View Article : Google Scholar : PubMed/NCBI
21	Singh P, Mathur SK, Singh S, Marwah N, Kalra R and Arora B: Cystic lymphangioma of the spleen-a case report. Indian J Pathol Microbiol. 48:202–203. 2005.PubMed/NCBI
22	Emir S, Sozen S, Yazar MF, Altinsoy HB, Arslan Solmaz O and Ozkan Z: Littoral-cell angioma of the spleen. Arch Iran Med. 16:189–191. 2013.PubMed/NCBI
23	Di Blasi A, Boscaino A, De Dominicis G and Marino-Marsilia G: Splenic hamartoma. Pathologica. 97:124–129. 2005.(In Italian). PubMed/NCBI
24	Delacruz V, Jorda M, Gomez-Fernandez C, Benedetto P and Ganjei P: Fine-needle aspiration diagnosis of angiosarcoma of the spleen: A case report and review of the literature. Arch Pathol Lab Med. 129:1054–1056. 2005.PubMed/NCBI
25	Kim HH, Hur YH, Koh YS, Kim JC, Kim HJ, Kim JW, Kim Y, Lee JH and Cho CK: Sclerosing angiomatoid nodular transformation of the spleen related to IgG4-associated disease: Report of a case. Surg Today. 43:930–936. 2013. View Article : Google Scholar : PubMed/NCBI
26	Delaitre B and Maignien B: Splenectomy by the laparoscopic approach. Report of a case. Presse Med. 20:22631991.(In French). PubMed/NCBI
27	Budzyński A, Demczuk S, Kumiega B, Migaczewski M, Matłok M and Zub-Pokrowiecka A: Sclerosing angiomatoid nodular transformation of the spleen treated by laparoscopic partial splenectomy. Wideochir Iinne Tech Maloinwazyjne. 6:249–255. 2011.
28	Kakisaka T, Kamiyama T, Yokoo H, Orimo T, Wakayama K, Tsuruga Y, Kamachi H, Harada T, Kato F, Yamada Y, et al: Hand-assisted laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen complicated by chronic disseminated intravascular coagulation: A case report. Asian J Endosc Surg. 7:275–278. 2014. View Article : Google Scholar : PubMed/NCBI
29	Kim KH, Lee S, Youn SH, Lee MR, Kim MC, Rha SH and Jung GJ: Laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen. Journal of the Korean Surgical Society. 80(Suppl 1): S59–S62. 2011. View Article : Google Scholar : PubMed/NCBI
30	Mohr Z, Klippel S, Spiethoff A, Trick D and Willis S: Laparoscopic splenectomy for sclerosing angiomatoid nodular transformation. Chirurg. 82:714–718. 2011.(In German). View Article : Google Scholar : PubMed/NCBI