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Erschienen in:
08.01.2019 | GI Image
Sclerosing Angiomatoid Nodular Transformation of the Spleen (SANT) with IgG4 Plasma Cells Infiltration
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 8/2019
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A 53-year-old female patient was presented to our hospital because of an incidental finding of a splenic mass during health check. She denied any abdominal symptoms. Contrast-enhanced computed tomography revealed a 4-cm low-density lesion with heterogeneous enhancement in the spleen (Fig. 1). Routine laboratory tests including carbohydrate antigen 19-9 level and white blood count were within reference range. A laparoscopic splenectomy was performed for the patient. Postoperative course was uneventful. Microscopically, at low magnification, there are multiple angiomatoid nodules submerged in a fibrosclerotic stroma, (Fig. 2a). At high magnification, plasma cells significantly infiltrated in the fibrosclerotic area, some of which presented large, atypical, or binuclear cells (Fig. 2b). Immunohistochemical examination reveals positive staining for CD31 (Fig. 2c), CD34 (Fig. 2d), SMA (Fig. 2e), and IgG4 (Fig. 2f).
Fig. 1
Contrast-enhanced computed tomography revealed a lesion with inhomogeneous enhancement in the spleen
Fig. 2
a There are multiple angiomatoid nodules submerged in a fibrosclerotic stroma (× 40). b Plasma cells significantly infiltrated in the fibrosclerotic area, some of which presented large, atypical, or binuclear cells (× 400). c Immunohistochemistry showed that the tumor was positive for CD31(× 400). d Immunohistochemistry showed that the tumor was positive for CD34 (× 400). e Immunohistochemistry showed that the tumor was positive SMA (× 400). f Immunohistochemistry showed that the tumor was positive IgG4 (× 400)
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