Littoral cell angiomas of the spleen associated with solid pseudopapillary tumor of the pancreas

Littoral cell angiomas: Benign lesion with a penchant for visceral malignancies

Littoral cell angiomas are rare vascular tumors of the spleen. Because of their rarity, unclear etiopathogenesis, and association with other malignancies, these tumors can pose diagnostic and therapeutic challenges. Due to paucity of published literature on this entity often limited to case reports, relevant data on this topic were procured and synthesized with the aid of a comprehensive Medline search in addition to oncologic, pathologic, radiologic, and surgical literature review on littoral cell angiomas. This article provides an in-depth review into postulated etiopathogenesis, pathology, clinical manifestations, associated malignancies, and prognostic features of littoral cell angiomas.

A rare vascular tumor of the spleen: Littoral cell angioma

INTRODUCTION

Being a rare benign vascular tumor of the spleen, Littoral cell angioma involves multiple focal nodules in the spleen and splenectomy is used for both definitive diagnosis and treatment.

PATIENTS AND METHODS

A 30-year-old male patient presented to our clinic with the complaints of intermittent abdominal pain and fever. In physical examination, splenomegaly was found and he was further evaluated with ultrasonography, tomography and magnetic resonance imaging that have revealed multiple solid mass lesions of various sizes in his spleen. The patient was administered open splenectomy and recovered uneventful.

RESULTS

After histopathological and immunohistochemical analyses of the splenectomy material, he was diagnosed with Littoral cell angioma.

CONCLUSIONS

For a timely diagnosis, Littoral cell angioma should be considered among the initial diagnoses in patients who were found to have splenomegaly in their physical examination and multiple masses in the spleen in radiological tests.

Computed tomography of the spleen: how to interpret the hypodense lesion

Background

As the largest single lymphatic organ in the human body, the spleen is responsible for central immunological and haematological tasks. Therefore, the spleen can be subject to a wide range of pathologic disorders. Computed tomography (CT) represents the most widely applied cross-sectional abdominal imaging technique and is considered the imaging modality of choice for the evaluation of numerous abdominal pathological conditions. Hypodense splenic lesions are frequently encountered on abdominal CT images. Although most hypodense lesions of the spleen can be considered benign, some findings and clinical conditions warrant closer attention to the lesion. CT offers a number of morphological criteria that can be applied to differentiate hypodense lesions of the spleen, such as a the appearance of a lesion’s borders, its attenuation, as well as the presence of calcifications or solid components.

Methods

This article reviews the most common splenic pathologies leading to hypodense appearances on CT images and illustrates the key CT imaging findings in the context of the clinical history of the patients.

Conclusion

The key imaging findings of hypodense splenic lesions are presented in order to aid interpretation during routine evaluation of abdominal CT images.

Teaching Points

• Haemangiomas, congenital in origin, represent the most common benign lesions of the spleen.

• Lymphoma represents the most common malignant tumour of the, usually secondarily involved, spleen.

• Most hypodense splenic lesions on CT represent benign lesions that require no further work-up.

• For correct interpretation, hypodense splenic lesions need to be evaluated in the clinical context.