Sclerosing angiomatoid nodular transformation of the spleen: multimodality imaging features and literature review

• Published in: BMC medical imaging Vol. 23; no. 1; pp. 50 - 8
• Main Authors: Chen, Ning-Xin, Wang, Ming-Liang, Wang, Hai-Xing, Zeng, Meng-Su
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06.04.2023; BioMed Central; BMC
• Subjects: Abdomen; Adult; Asymptomatic; Blood vessels; Calcification; CD34 antigen; CD8 antigen; Computed tomography; Computed tomography imaging(CT); CT imaging; Diagnosis; Diagnostic imaging; Differential diagnosis; Evaluation; Female; Habitus; Histiocytoma, Benign Fibrous - diagnostic imaging; Histiocytoma, Benign Fibrous - surgery; Homogeneity; Humans; Image contrast; Image enhancement; Immunohistochemistry; Lesions; Literature reviews; Magnetic resonance imaging; Magnetic resonance imaging (MRI); Male; Medical imaging; Medical research; Medicine, Experimental; Middle Aged; Patients; Positron emission; Positron Emission Tomography Computed Tomography; Sclerosing angiomatoid nodular transformation; Spleen; Tomography; Tomography, X-Ray Computed; Tumors; Young Adult; Magnetic resonance imaging (MRI); Sclerosing angiomatoid nodular transformation; Computed tomography imaging(CT)
• ISSN: 1471-2342; 1471-2342
• DOI: 10.1186/s12880-023-01008-3

The purpose of this study was to evaluate the CT and MRI findings, clinicopathologic features, and differential diagnosis of Sclerosing angiomatoid nodular transformation (SANT). Seven men and seven women with pathological diagnoses of SANT were included in this retrospect study. Patients underwent at least one radiological examination before surgery. The number, shape, margin, size, attenuation, signal intensity, homogeneity, and enhancing pattern of the lesion were evaluated by two abdominal radiologists independently. Immunohistochemistry reports were available for 11 patients. The immunoreactivity to the vascular markers CD8, CD31, and CD34 was assessed. The 14 SANT patients (7 men, 7 women; mean age, 43.5 years; age range, 24-56 years) presented with a single lesion and showed no specific clinical symptoms. Among 14 patients, 12 patients underwent MR scan, 5 patients underwent CT scan and 3 patients underwent PET-CT. On CT, all 5 lesions showed hypodensity on non-contrast images and spoke-wheel enhancing pattern after contrast administration, and calcification was observed. On T2WI, 10 cases(83.3%)showed hypointensity and 2 cases (16.7%) showed hyperintensity with central hypointensity. On T1WI, 10 cases (83.3%) were isointense and 2 cases (16.7%) were slightly hypointense. 10 cases (83.3%) showed hypointensity on DWI and 2 cases (16.7%) showed slightly hyperintensity on DWI. After contrast administration, all 12 lesions showed progressive enhancement. 18 F-fluorodeoxyglucose (FDG) uptake in the tumor was seen in all three cases that underwent PET-CT. The maximum standardized uptake value (SUVmax) was 4.5, 5.1, and 3.8 respectively. Apart from the progressive spoke-wheel enhancing pattern, DWI and ADC findings will add value to the diagnosis of SANT.