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Valizadeh P, Jannatdoust P, Tahamtan M, Soleimani Dorcheh S, Khalaj F, Ghorani H, Ayoobi Yazdi N, Salahshour F. Differentiating malignant from benign splenic lesions: a meta-analysis and pictorial review of imaging features. Abdom Radiol (NY) 2024; 49:2833-2857. [PMID: 38900328 DOI: 10.1007/s00261-024-04447-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES Splenic lesions might exhibit overlapping imaging features, varying from benign entities like cysts and hemangiomas to malignancies such as lymphoma and angiosarcoma. This meta-analysis aims to delineate imaging characteristics that distinguish malignant from benign splenic lesions. METHODS Adhering to PRISMA guidelines, we searched PubMed, Scopus, and Web of Science for studies on imaging features differentiating malignant from benign splenic lesions. We extracted data on splenic pathology and imaging characteristics and assessed the methodological quality via QUADAS-2. Odds ratio meta-analyses were performed using STATA (Version 17.0, Stata Corp, College Station, TX). RESULTS Portal phase hypoenhancement, hypovascular enhancement pattern, diffusion restriction, and late phase hypoenhancement, with odds ratios above 10, highly indicate malignancy. Other features suggestive of malignancy include solid morphology, lymphadenopathy, presence of perisplenic fluid, arterial hypoenhancement, hypoechogenicity on ultrasound, splenomegaly, and presence of multiple lesions. In contrast, cystic morphology, hypervascular-washout and hypervascular-persistent pattern of enhancement, late phase hyperenhancement, anechogenicity on ultrasound, portal phase hyperenhancement, well-defined borders, and calcification are in favour of benign pathology. CONCLUSION The study underscores the critical role of contrast-enhanced and diffusion-weighted imaging in distinguishing malignant from benign splenic lesions, emphasizing the role of features like portal phase hypoenhancement and restricted diffusion in diagnosing malignancies. Additionally, the study emphasizes the value of contrast-enhanced ultrasound, which allows for the visualization of key contrast-enhancement patterns without the risk of ionizing radiation exposure.
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Affiliation(s)
- Parya Valizadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Jannatdoust
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Tahamtan
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Science, Tehran, Iran
| | - Soroush Soleimani Dorcheh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Student's Scientific Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Fattaneh Khalaj
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Ghorani
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Science, Tehran, Iran
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Ayoobi Yazdi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Science, Tehran, Iran
| | - Faeze Salahshour
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Science, Tehran, Iran.
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2
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Wang W, Qi G, Zhao X, Zhang Y, Zhu R, Liang R, Sun Y. Clinical Landscape of Littoral Cell Angioma in the Spleen Based on a Comprehensive Analysis. Front Oncol 2022; 12:790332. [PMID: 35211400 PMCID: PMC8861295 DOI: 10.3389/fonc.2022.790332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/12/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Littoral cell angioma (LCA) is currently considered to be a rare splenic tumor with malignant potential. As the epidemiology, pathogenesis, clinical manifestation, treatment, and prognosis remain unclear, the clinical diagnosis and treatment of LCA have not been standardized. Hence, we performed a comprehensive analysis of 189 observational studies comprising 435 patients to improve the current status of diagnosis and treatment. Methods PubMed, Embase, WanFang and CNKI were searched from inception to May 2021 to identify LCA studies that were published in English and Chinese. The clinical information of LCA patients were extracted and analyzed. Results The LCA has a male-to-female ratio of 0.90 and a solitary-to-multiple ratio of 0.31. In terms of clinical features, 69.7% of the patients showed splenomegaly, 49.7% were asymptomatic, and 39.2% experienced epigastric discomfort. As the imaging findings of patients with LCA were nonspecific, an image-guided biopsy (10/12) was a safe and effective method for diagnosing in this condition. Notably, results of the prognostic analysis indicated that LCA has a lower risk of recurrence and metastasis. The patient may develop a stable disease or the tumor will grow but will not metastasize. Besides, the novel immunohistochemical pattern of LCA was described as CD31+/ERG+/FVIII Antigen+/CD68+/CD163+/lysozyme+/CD8−/WT1−. Conclusion LCA should be reconsidered as a benign primary splenic vascular neoplasm, which is more like an intra-splenic manifestation of abnormal body function. Image-guided biopsy with follow-up might be a beneficial choice for LCA patients. For LCA patients with abdominal discomfort, pathological uncertainty or continuous tumor enlargement, splenectomy remains the preferred treatment.
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Affiliation(s)
- Weijie Wang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guangzhao Qi
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiangtian Zhao
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yanping Zhang
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rongtao Zhu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruopeng Liang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuling Sun
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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3
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Yaney A, Jones D, Perry KA, Jhawar SR. Rare case of littoral cell angioma recognised on CT simulation for adjuvant radiation treatment for early stage breast cancer. BMJ Case Rep 2022; 15:e248167. [PMID: 35131803 PMCID: PMC8823223 DOI: 10.1136/bcr-2021-248167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 11/04/2022] Open
Abstract
A 63-year-old woman with pathological anatomic/prognostic stage IA ER+/PR+/HER2- multifocal invasive mammary carcinoma with mixed ductal and lobular features of the left breast underwent lumpectomy with sentinel lymph node biopsy. During evaluation of the CT simulation for adjuvant radiation (RT) treatment planning, a liver lesion and splenomegaly were noted. A subsequent MRI abdomen revealed a large, indeterminate splenic lesion with a wide differential and a benign liver cyst. The patient ultimately underwent splenectomy, with pathology consistent with littoral cell angioma, a rare entity associated with several malignancies. At last follow-up, 7 months after completion of RT, she remained cancer free while on anastrazole and was doing well clinically.
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Affiliation(s)
- Alexander Yaney
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Daniel Jones
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kyle A Perry
- Department of General Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sachin R Jhawar
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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4
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Bhojwani R, Vijay K, Goyal L, Jain N, Gupta S, Faujdar M. Littoral Cell Angioma of Spleen: a Rare but Important Differential for Splenic Lesions. Indian J Surg 2019. [DOI: 10.1007/s12262-018-1837-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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5
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Cafferata B, Pizzi M, D'Amico F, Mescoli C, Alaggio R. Sclerosing Angiomatoid Nodular Transformation of the spleen, focal nodular hyperplasia and hemangioma of the liver: A tale of three lesions. Pathol Res Pract 2016; 212:855-8. [PMID: 27450658 DOI: 10.1016/j.prp.2016.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 07/04/2016] [Indexed: 12/19/2022]
Abstract
Sclerosing Angiomatoid Nodular Transformation (SANT) of the spleen is a benign vascular lesion with peculiar histological features. The pathogenesis of SANT is still largely unknown and variable etiologies have been proposed, including autoimmune, inflammatory, and/or vascular disorders. The present report describes a unique case of splenic SANT, associated with focal nodular hyperplasia and a sclerosing hemangioma of the liver. The clinic-pathological features of such an unusual case are thoroughly illustrated. Its possible pathogenic mechanisms are also briefly addressed.
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Affiliation(s)
- Barbara Cafferata
- General Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Marco Pizzi
- General Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
| | - Francesco D'Amico
- Hepatobiliary Surgery and Liver Transplantation Unit, University of Padova, Padova, Italy
| | - Claudia Mescoli
- General Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Rita Alaggio
- General Pathology & Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
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6
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Bailey A, Vos J, Cardinal J. Littoral cell angioma: A case report. World J Clin Cases 2015; 3:894-899. [PMID: 26488026 PMCID: PMC4607808 DOI: 10.12998/wjcc.v3.i10.894] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/21/2015] [Accepted: 08/07/2015] [Indexed: 02/05/2023] Open
Abstract
Primary splenic lesions are rare entities among which littoral cell angioma (LCA) is a recently described, uncommon vascular lesion that is unique to the spleen. It has heretofore been described primarily in pathologic series and has been found mostly to behave as a benign entity. A few reports of malignant variants have been reported. We present a case report of a solitary LCA discovered after splenectomy for an incidentally discovered splenic lesion, along with a literature review.
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7
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Namdaroglu OB, Sevim Y, Yildirim O, Ozhamam E, Kocer B. Littoral cell angioma of the spleen: case report and literature review. Eur Surg 2015. [DOI: 10.1007/s10353-015-0332-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Zhang YH, Liu LM, Wang WP, Ding H, Wang XN, Xia HS. Littoral cell angioma of the spleen: sonographic-pathologic comparison. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:691-697. [PMID: 23525396 DOI: 10.7863/jum.2013.32.4.691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the sonographic and pathologic features of littoral cell angioma of the spleen in 7 patients. METHODS The sonographic appearance in 7 cases of littoral cell angioma confirmed by surgical pathologic examination was retrospectively reviewed. All underwent color Doppler imaging. Two underwent contrast-enhanced sonography. The sonographic appearance was compared with pathologic findings. RESULTS Splenic lesions were solitary in 5 cases and multiple in 2 cases. The masses ranged from 10 to 64 mm in maximum diameter. Five hypoechoic and 2 hyperechoic lesions on grayscale sonography corresponded to few and multiple blood-filled spaces on pathologic examination, respectively. Four hypovascular lesions, 1 hypervascular lesion, and the other 2 hypervascular lesions full of color flow signals on color Doppler imaging corresponded to few, several, and multiple arteries on pathologic examination. On contrast-enhanced sonography, 1 hypervascular lesion full of color flow signals showed homogeneous hyperenhancement for 8 minutes during the arterial and parenchymal phases. One hypovascular lesion showed inhomogeneous isoenhancement transiently during the arterial phase and became hypoechoic later. CONCLUSIONS Littoral cell angioma is a primary vascular splenic neoplasm with variable features on grayscale sonography and color Doppler imaging as well as contrast-enhanced sonography. The sonographic appearance of littoral cell angioma mainly depends on the type and number of tumor vessels.
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Affiliation(s)
- Yun-Hua Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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9
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Gupta P, Peungjesada S, Foshee S, Amirkhan RH. Littoral cell angioma of spleen: an uncommon presentation of a rare neoplasm. J Clin Imaging Sci 2012; 2:69. [PMID: 23393626 PMCID: PMC3551492 DOI: 10.4103/2156-7514.104302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 09/27/2012] [Indexed: 02/06/2023] Open
Abstract
Littoral cell angioma (LCA) is a rare primary splenic tumor that is difficult to differentiate preoperatively from other benign and malignant splenic lesions. Most of the cases present as multiple nodules in the spleen. We report a case of large solitary LCA of the spleen, an uncommon presentation. LCA should be considered in the differential diagnosis of multiple and solitary splenic lesions.
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Affiliation(s)
- Pramod Gupta
- Radiology Service, Dallas VA Medical Center, VA North Texas Health Care System, Dallas, USA
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10
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Littoral cell angioma and angiosarcoma of the spleen: report of two cases in siblings and review of the literature. J Gastrointest Surg 2012; 16:863-7. [PMID: 22068970 DOI: 10.1007/s11605-011-1773-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 10/26/2011] [Indexed: 01/31/2023]
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11
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Koh MA, Nandakumar L. Littoral cell angioma: a case report and review of recent literature. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32839-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Hu ZQ, A YJ, Sun QM, Li W, Li L. The splenic Littoral cell angioma in China: a case report and review. World J Surg Oncol 2011; 9:168. [PMID: 22172167 PMCID: PMC3271992 DOI: 10.1186/1477-7819-9-168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 12/15/2011] [Indexed: 01/18/2023] Open
Abstract
Littoral cell angioma (LCA) is a rare splenic vascular neoplasm that arises from the cells lining the red pulp sinuses. It is deemed to be a benign and incidental lesion. The earliest literature report of littoral cell angioma has been described by Falk. The examination of samples after splenectomy reveals similar pathological change and its change rule is summarized. However, many recent reports have described it to be a malignant tumor with congenital and immunological associations. Generally speaking, the definitive diagnosis can only be made after histological and immunohistochemical profiles. In this case report, we presented the case of a 48-year-old woman with multiple splenic LCAs. Initially, the patient was characteristics of abdominal distension, weakness and fatigue. Multiple hemangiomas were observed in the spleen through abdominal ultrasonic diagnosis. Computed tomography (CT) scans revealed the splenomegaly with multiple round and hyperdense lesions. The patient subsequently underwent splenectomy. Postoperative histological and immunohistochemical studies confirmed the diagnosis of LCA. Based on the presentation of this case, clinical, radiographic and pathological results of LCA as well as recent advances in our understanding of this uncommon splenic lesion were reviewed. LCA is an uncommon splenic tumor diagnosed in patients with or without abdominal discomfort. Only a few case reports regarding this kind of tumor have been published as inconsistent results. In the present paper, we have reported a case of LCA and reviewed the literature.
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Affiliation(s)
- Zong-Qiang Hu
- Ganmei Affiliated Hospital of Kunming Medical University, Kunming, China
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13
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Nagarajan P, Cai G, Padda MS, Selbst M, Kowalski D, Proctor DD, Chhieng D, Aslanian HR, Harigopal M. Littoral cell angioma of the spleen diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy. Diagn Cytopathol 2011; 39:318-22. [PMID: 21488173 DOI: 10.1002/dc.21384] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Littoral cell angiomas are uncommon primary vascular neoplasms that arise from the sinusoidal lining or littoral cells of the splenic red pulp, and hence are unique to the spleen. We report a case of littoral cell angioma in 34-year-old woman, which was diagnosed by endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB). The cytologic features of littoral cell angiomas have been described only in three previous case reports, one of which was a bench-top aspirate. In our case, we have utilized the fine-needle aspiration samples obtained by a linear endoscopic ultrasound examination for establishing the diagnosis. The characteristic cytologic features identified on the smears along with immunohistochemical analysis performed on the compact cellblock prepared from the aspirate aided in the confirmation of the diagnosis. We suggest that EUS-FNAB is a safe and reliable method in the diagnosis of vascular lesions of the spleen.
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Affiliation(s)
- Priyadharsini Nagarajan
- Department of Pathology, Cytopathology, Yale University, School of Medicine, New Haven, CT, USA
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Pilz JB, Sperschneider T, Lutz T, Loosli B, Maurer CA. Littoral cell angioma in main and accessory intrapancreatic spleen presenting as splenic rupture. Am J Surg 2010; 201:e15-7. [PMID: 20409532 DOI: 10.1016/j.amjsurg.2009.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/24/2009] [Accepted: 11/24/2009] [Indexed: 01/13/2023]
Abstract
We report the incidental finding of a nodular mass in the pancreatic tail on a contrast-enhanced computed tomography scan preinterventional to emergency laparotomy for splenic rupture. Because of the past surgical history and radiologic appearance, differential diagnosis included atypical lymphoma in the spleen and regional lymph node, pancreatic adenocarcinoma with splenic metastasis, and intrapancreatic metastase of malignant melanoma; the patient underwent both splenectomy and pancreatic tail resection. A diagnosis of littoral cell angioma in main and accessory intrapancreatic spleen was made. To our knowledge, this is the first description of littoral cell angioma of the spleen involving both main and accessory organ presenting as splenic rupture.
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Affiliation(s)
- Julia B Pilz
- Department of Gastroenterology, Liestal Hospital, Switzerland
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15
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Berman E, Ikpatt F, Wang D, Dembner A, Zauber NP. Rapid progression of littoral cell angioma of the spleen in a man with multiple infections. Rare Tumors 2010; 2:e17. [PMID: 21139945 PMCID: PMC2994494 DOI: 10.4081/rt.2010.e17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 03/04/2010] [Accepted: 03/05/2010] [Indexed: 01/04/2023] Open
Abstract
Littoral cell angioma is an uncommon primary vascular neoplasm of the spleen. It frequently follows a benign course, but cases with aggressive behavior have been described. We present a case of this rare disease highlighting radiological examinations showing a rapid increase in the size of the spleen as well as an increase in the number and size of existing nodules. We also discuss the relationship of this disorder to chronic infections and its possible association with Epstein Barr virus.
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Affiliation(s)
- Errol Berman
- Saint Barnabas Medical Center, Livingston, New Jersey, USA
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16
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Chourmouzi D, Psoma E, Drevelegas A. Littoral cell angioma, a rare cause of long standing anaemia: a case report. CASES JOURNAL 2009; 2:9115. [PMID: 20062692 PMCID: PMC2803912 DOI: 10.1186/1757-1626-2-9115] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 11/30/2009] [Indexed: 12/19/2022]
Abstract
Littoral cell angioma is a rare primary splenic tumor that is difficult to differentiate preoperatively from other benign and malignant splenic lesions. We report a case of littoral cell angioma of the spleen in a 51-year-old woman that presented with long standing anaemia.
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Affiliation(s)
- Danai Chourmouzi
- Department of Diagnostic Radiology, Interbalcan Medical Center, Thessaloniki, Greece
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17
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Ertan G, Tekes A, Mitchell S, Keefer J, Huisman TAGM. Pediatric littoral cell angioma of the spleen: multimodality imaging including diffusion-weighted imaging. Pediatr Radiol 2009; 39:1105-9. [PMID: 19597808 DOI: 10.1007/s00247-009-1339-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 05/26/2009] [Accepted: 06/10/2009] [Indexed: 12/17/2022]
Abstract
Littoral cell angioma (LCA) is a rare primary splenic vascular tumor originating from littoral cells lining the splenic red pulp sinuses. LCAs are rarely seen in children. We present the US, CT, and MRI findings including diffusion-weighted imaging (DWI) in a 2-year-old boy with histologically proven LCA. Previous studies on liver lesions have shown that DWI allows differentiation of vascular tumors from primary neoplasms and metastatic disease. The current case indicates that increased ADC values within the splenic lesions suggest a vascular etiology, which might help narrow the differential diagnosis.
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Affiliation(s)
- Gulhan Ertan
- Division of Pediatric Radiology, Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287-0842, USA
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