Abstract
Sclerosing angiomatoid nodular transformation (SANT) is a relatively new entity in the spleen, which usually presents in the form of single nodule. Only 5 multifocal SANT cases have been reported in English literature. The present case is the first report of a 38-years-old male patient with SANT in the form of multiple nodules, who has been cured via laparoscope. In comparison to solitary SANT, multifocal SANT occurs more likely in males than females and association with malignant neoplasm has not been described yet. Multifocal SANT as well as solitary SANT show some relationships with IgG4-related sclerosing disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s13000-015-0312-2) contains supplementary material, which is available to authorized users.
Highlights
Sclerosing angiomatoid nodular transformation (SANT) is one kind of very rare benign lesion in the spleen, which may present as ., Solitary type or Multifocal type SANT
We reported a case of multifocal SANT managed at our hospital and retrospectively reviewed medical records of 127 patients with SANT reported in English literature, including 97 cases reported by Falk et al [5] in March 2012 and the additional 30 cases reported by other investigators dated from March 2012 to present(shows this in more detail in the Additional file 1: Table S1)
In summary, we reported a unique patient with multiple nodules of SANT of the spleen who underwent laparoscopic splenectomy successfully
Summary
Sclerosing angiomatoid nodular transformation (SANT) is one kind of very rare benign lesion in the spleen, which may present as ., Solitary type or Multifocal type SANT. We present a new case of multifocal SANT that had been treated with laparoscopic splenectomy successfully. On August 2012, abdominal CT scan was performed for the patient, which showed an enlarged spleen, with multifocal lobulated or irregular nodules in the spleen parenchyma. These nodules were isodense or hypodense, well-defined boundary, which were 3.5 cm, 5.5 cm and 7.6 cm in diameter respectively (Fig. 1a). The delayed enhanced imaging showed that the lesion was progressively enhanced toward its center, becoming nearly isodense to the normal spleen According to these imaging manifestations, the patient was initially diagnosed as multiple angioma, while metastatic neoplasm could not be completely excluded. In the sclerotic stroma we can found some plasma cells which revealed IgG+ (Fig. 2e) and some of which showed IgG4+ (Fig. 2f) (
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