Abstract:

Objective: To explore the clinicopathological characteristics of sclerosing angiomatoid nodular transformation (SANT) of spleen. Methods Eight cases diagnosed with SANT of spleenin our hospital from 2010 to 2019 were enrolled. Routine pathology and immunohistochemical staining were performed. The clinical symptoms, imaging examination and pathological features of SANT of spleen were analyzed respectively. Results Among the 8 cases, there were 4 males and 4 females, aged from 3 to 67 years old. Five cases had no obvious clinic symptoms, two cases showed abdominal pain.One case had a mass in the left upper abdomen. B-ultrasound showed occupying lesions in the spleen. Further examination revealed a round-shaped low-density mass in the spleen by CT scan, and there was no obvious enhancement under contrast-enhanced CT. The maximum diameter of the tumor was 1.5 cm-11.0 cm with relatively clear boundaries. The section of the mass was gray-brownin color and solid, and the gray-white fiber strips near the section center were divided to form a star-shaped scar. HE staining showed there were many angiomatoid-like nodules scattered in the background of fibroproliferative sclerosis. The vascular lumen in the nodules was irregularly dilated, and there werelots of red blood cells in the lumen. The nodules were fibrously separated or arranged in concentric circles. The spindle cells were wrapped around. Immunohistochemistry revealed that the expressions of CD31, CD34 and CD8 in vascular endothelial cells were varied in nodular lesions. The surrounding spindle cells were positive for CD68, and focally positive for SMA. No recurrence or metastasis was found during 2 to 104 months of follow-up. Conclusions SANT is currently considered as a benign proliferative neoplastic lesion. There is no significant difference in ratio between men and women. Most patients have no obvious clinical manifestations, few of them are characterized by abdomen pain. CT scan usually shows a low-density tumor with no obvious enhancement under contrast-enhanced CT. Surgical resection is the primary treatment for SANT. Postoperative pathological and immunohistochemical staining are important methods for the final diagnosis.

Key words: Sclerosing angiomatoid nodular transformation, Spleen, Clinicopathological analysis, Differential diagnosis