Sclerosing Angiomatoid Nodular Transformation of the spleen (SANT)

This is a rare but benign disease that is often an incidental finding or may present with abdominal pain or discomfort and splenic enlargement. The mean age is 48.4 years with a predominance of cases occurring in women. Examination of the spleen reveals a solitary nodule that can vary from 3-17 cm that is demarcated from the surrounding spleen. Microscopic evaluation reveals multiple nodules composed of vascular slit-like spaces and lined by plump endothelial cells. There may be broad bands of hyalinization or concentric rings of collagen encircling some of the nodules. The nodules contain numerous extravasated red blood cells and chronic inflammatory cells. Immunohistochemical analysis suggests these nodules are derived from red pulp. It is hypothesized that these nodules represent red pulp entrapped by a nonneoplastic stromal proliferation. The lesion is benign.

Am J Surg Pathol 2004;28:1268-1279.

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