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Presented by Pedram Argani, M.D. and prepared by Hillary Ross, M.D.
Case 3: This is a 67 year old male with a 5 cm splenic mass found on imaging.
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1. Question
Week 435: Case 3
This is a 67 year old male with a 5 cm splenic mass found on imaging.images/1alex/05102010case3image1.jpg
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images/1alex/05102010case3image3.jpgCorrect
Answer: Sclerosing Angiomatoid Nodular Transformation (SANT)
Histology: This splenic lesion has a multinodular appearance. Nodules are surrounded by concentric rings of collagen with lymphocytes and plasma cells. The nodules contain slit- like vessels lined by plump endothelial cells and spindle cells.
Discussion: None of the entities in the differential diagnosis demonstrate the characteristic concentric collagen rings and multinodular angiomatoid appearance of SANT. Hemangiomas are monotonous and contain bland endothelial lining cells. Littoral cell angioma demonstrates a pseudopapillary architecture and lacks sclerosis. Hamartomas are not nodular, and are ill-defined.
SANT is thought to represent altered red pulp entrapped by a non-neoplastic stromal proliferative process.
Reference(s):
– American Journal of Surgical Pathology 2004; 28:1268-1279.Incorrect
Answer: Sclerosing Angiomatoid Nodular Transformation (SANT)
Histology: This splenic lesion has a multinodular appearance. Nodules are surrounded by concentric rings of collagen with lymphocytes and plasma cells. The nodules contain slit- like vessels lined by plump endothelial cells and spindle cells.
Discussion: None of the entities in the differential diagnosis demonstrate the characteristic concentric collagen rings and multinodular angiomatoid appearance of SANT. Hemangiomas are monotonous and contain bland endothelial lining cells. Littoral cell angioma demonstrates a pseudopapillary architecture and lacks sclerosis. Hamartomas are not nodular, and are ill-defined.
SANT is thought to represent altered red pulp entrapped by a non-neoplastic stromal proliferative process.
Reference(s):
– American Journal of Surgical Pathology 2004; 28:1268-1279.
