Abstract
Background Sclerosing angiomatoid nodular transformation of the spleen (SANT) is an uncommon, usually incidental, nonneoplastic vascular splenic lesion first described in 20041. Recent articles have suggested association of SANT with IgG4-related sclerosing disease and with Epstein-Barr virus RNA expression2. Aim A retrospective review of SANT cases reported in three Perth metropolitan hospitals over the past 20 years. Methods A computer-assisted search of all reported SANT cases from the Perth metropolitan hospital Anatomical Pathology database for the period 1992-2012 was performed. Slides were reviewed from the identified cases and, where formalin-fixed paraffin-embedded (FFPE) tissue was available, further immuno-histochemical stains were performed including CD8, CD30, CD31, CD34, D2-40, ERG, CD138, IgG, IgG4 and EBV-encoded small RNA (EBER). Results Four cases were identified, including three splenectomy specimens and one post-mortem specimen. All had the characteristic CD31/CD34/CD8 vascular immunophenotype1. Endothelial expression of CD30 was found in two of the cases. Architectural derangement was highlighted by an altered pattern of ERG immu-noperoxidase nuclear expression in the sinusoidal epithelium of SANT angiomatoid nodules. EBER was negative in the three cases with available FFPE material and no convincing evidence for IgG4-related sclerosing disease was identified. Conclusion Four cases of SANT are described, including immunohistochemical adjuncts to their diagnosis. No evidence for an association with EBV infection or IgG4-related sclerosing disease is identified in these cases.
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