Multimodality imaging of splenic sclerosing angiomatoid nodular transformation

Abstract

Sclerosing angiomatoid nodular transformation (SANT) is an exceedingly rare, benign and proliferative vascular lesion that arises from the splenic red pulp. It is often an incidental finding on imaging. The diagnosis of SANT is confirmed via histopathological examination of the resected spleen. Herein, we present a case of SANT and describe its typical imaging characteristics. An asymptomatic 39-year-old man was found to have a 3.1 cm × 2.7 cm × 2.3 cm hypoechoic splenic lesion during abdominal ultrasonography, which was performed to investigate his elevated gamma-glutamyl transpeptidase and alanine transaminase levels. Contrast-enhanced computed tomography suggested a vascular splenic lesion, while magnetic resonance imaging demonstrated features consistent with SANT. In view of the increasing size of the lesion on follow-up imaging, the patient elected for splenectomy. Histopathological examination confirmed SANT, and the lesion was completely resected by laparoscopic splenectomy.