Radiology–Pathology ConferenceLittoral cell angioma☆
Introduction
Littoral cell angioma (LCA) is a recently recognized primary vascular tumor of the spleen, which was first described by Falk et al. [1]. Since then, only 43 additional cases have been reported in the English literature. While the CT and ultrasound (US) features of this tumor have been well described, there is a lack of specificity in differentiating the tumor from other primary vascular splenic tumors, namely, hemangiomas and angiosarcomas. An efficient and minimally invasive way to diagnose LCA is needed in order to avoid unnecessary surgery or potentially harmful therapies. The recent description of a potential malignant variant of LCA, along with its apparent association with a spectrum of concurrent malignancies and immune-related diseases, has raised concerns regarding the appropriate management and follow-up.
Section snippets
Case study
A healthy 54-year-old Caucasian woman presented with left upper quadrant abdominal pain and left flank pain. Her medical history was significant for hypothyroidism with replacement therapy and hysterectomy for fibroids. She underwent a US of the kidneys, which demonstrated a 1-cm hyperechoic renal lesion thought to most likely represent an angiomyolipoma. For further evaluation, she underwent an abdominal CT with (Fig. 1A) and without contrast (GE Lightspeed 16-slice MDCT, GE Medical Systems,
Discussion
LCA is a recently recognized primary vascular lesion of the spleen, which was first described by Falk et al. [1] in 1991. Since then, 43 additional cases have been described in the English literature. Although the histologic, immunohistochemical, CT, and US characteristics of LCA have been well described, there is limited description of its MRI and scintigraphic imaging features. Since the CT and US characteristics are nonspecific, it is important to further examine the imaging characteristics
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Cited by (24)
Incidental littoral cell angioma of the spleen: cross-sectional imaging findings and review of the literature
2022, Radiology Case ReportsCitation Excerpt :Since the littoral cells have features intermediate between endothelial cells and macrophages, they show a hybrid endothelial-histiocytic phenotype on immunohistochemical staining. Immunohistochemically, LCA is characteristically CD 34 negative, CD 68 positive, CD 31 positive, 21 positive, and 8 negatives [31]. Additionally, the epithelial cells in LCA do occasionally express S-100 protein [32].
Littoral cell angioma of the spleen
2009, Asian Journal of SurgeryClinical Landscape of Littoral Cell Angioma in the Spleen Based on a Comprehensive Analysis
2022, Frontiers in OncologyLittoral cell angioma of the spleen: A case report
2019, Malta Medical JournalHuge Littoral Cell Angioma of the Spleen: A Case Report
2019, Journal of Nippon Medical SchoolLaparoscopic splenectomy for littoral cell angioma of the spleen A case report
2019, Medicine (United States)
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This article has received a waiver from the hospital IRB committee.