Elsevier

Clinical Imaging

Volume 31, Issue 1, January–February 2007, Pages 27-31
Clinical Imaging

Radiology–Pathology Conference
Littoral cell angioma

https://doi.org/10.1016/j.clinimag.2006.09.021Get rights and content

Abstract

Littoral cell angioma (LCA) is an extremely rare primary splenic tumor. There are few MRI and scintigraphic characteristics described. These characteristics may be most helpful in differentiating LCA from other primary vascular tumors. We present a 54-year-old woman found on CT to have a 7-cm mass within an enlarged spleen. LCA was diagnosed by ultrasound (US)-guided biopsy. She was successfully treated with laparoscopic splenectomy. The CT, MRI, US, and Tc99m-RBC scan characteristics are described along with histologic and immunohistochemical correlation.

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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This article has received a waiver from the hospital IRB committee.

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