Is sclerosing angiomatoid nodular transformation (SANT) of the splenic red pulp identical to inflammatory pseudotumour? Report of 16 cases

Diébold, J; Tourneau, A. Le; Marmey, B.; Prévôt, Sophie; Müller-Hermelink, H. K.; Sevestre, H; Molina, Thierry Jo; Billotet, C.; Gaulard, Philippe; Knopf, J.-F.; Bendjaballah, S.; Mangnan-Marai, A.; Brière, Josette; Fabiani, Bettina; Audouin, Josée

doi:10.1111/j.1365-2559.2008.03101.x

Cited by 77 publications

(60 citation statements)

References 8 publications

(15 reference statements)

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“…This suggests the possibility of a secondary response possibly to vascular obstruction and/or intratumoral thrombosis. In fact, sclerosing angiomatoid nodular transformation-like features can be commonly seen in the presence of thrombosed vessels, occurring both in reactive (eg thrombosed hemorrhoids) as well as neoplastic settings (eg surrounding metastases), as also suggested by Diebold et al 38 Sclerosing angiomatoid nodular transformation-like lesions have been described in spleens involved by carcinomas 39 and in the presence of splenic extramedullary hematopoiesis, particularly in cases with large extramedullary hematopoiesis nodules associated with sclerosis, a lesion also known as sclerosing extramedullary hematopoietic tumor. 40 In a proportion of these cases, the presence of fibrotic stroma containing CD34-positive capillaries, but devoid of CD8-positive sinuses, result in a distinct nodularity and a close resemblance to sclerosing angiomatoid nodular transformation (Orazi, unpublished observation).…”

Section: Discussionmentioning

confidence: 59%

“…Similar lesions have been described by others. 36,37 In a more recent series of sclerosing angiomatoid nodular transformation cases, published by Diebold et al, 38 one of the lesions was found adjacent to a splenic hemangioma. This suggests the possibility of a secondary response possibly to vascular obstruction and/or intratumoral thrombosis.…”

Section: Discussionmentioning

confidence: 98%

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Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma

et al. 2011

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Splenic hamartoma is a rare tumor-like lesion composed of structurally disorganized red pulp elements. It has been hypothesized that two other splenic lesions, cord capillary hemangioma and myoid angioendothelioma, may fall within the spectrum of splenic hamartoma, simply representing morphological variants. In this study, we compared the vascular and stromal composition of cord capillary hemangioma and myoid angioendothelioma with those of classical hamartoma. In addition, we assessed the clonal vs polyclonal nature of the lesions in nine female cases by performing clonality analysis for X-chromosome inactivation at the human androgen receptor locus (HUMARA) on laser-assisted microdissected samples. In 15 of 17 cases, increased reticulin and/or collagen content was observed. The classical hamartoma cases showed a vasculature predominantly composed of CD8 þ CD31 þ CD34À splenic sinuses, whereas cases of cord capillary hemangioma and myoid angioendothelioma contained many CD8À CD31 þ CD34 þ cord capillaries, but very little CD8 þ vasculature. All cases lacked expression of D2-40 and Epstein Barr virus-encoded RNA. All cases showed a proliferation index of r5% by Ki-67. Cases of classical hamartoma lacked significant perisinusoidal expression of collagen IV and low-affinity nerve growth factor receptor. Both markers were variably expressed in the other lesions. Increased CD163-positive histiocytes were found in four cases (three cord capillary hemangiomas and one myoid angioendothelioma). HUMARA analysis was informative in all nine tested cases, of which three cases showed a non-random X-chromosome inactivation pattern, indicating clonality. All three clonal cases were cord capillary hemangiomas. Our study has shown that in spite of considerable morphologic heterogeneity and overlapping features, classical hamartoma and cord capillary hemangioma and myoid angioendothelioma are different in terms of their vascular and stromal composition. Clonality analysis supports a true neoplastic origin for the cord capillary hemangioma. A larger study using additional immunohistochemical and molecular studies is necessary to further evaluate the biological significance of the current findings.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 98%

Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma

et al. 2011

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“…EBV (in situ hybridization for EBER) has been found in spleen and liver IPT in higher frequency than in lymph node (66%, 50% and 20%, respectively [20,38,[47][48][49][50]. Tuberculosis should be included in differential diagnosis [51], as well as sclerosing angiomatoid transformation of the spleen [52][53][54].…”

Section: Inflammatory Pseudotumor In Lymph Nodes and Spleenmentioning

confidence: 99%

Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

et al. 2017

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Follicular dendritic cell (FDC) tumor is an uncommon neoplasm. It generally presents as a slow-growing, painless mass, without systemic symptoms. Histological features usually include low grade spindle cell proliferation. This tumor occurs primarily in lymph nodes, especially cervical and axillary, however, involvement of extranodal sites such as the tonsils, spleen, liver, and gastrointestinal tract has been reported. Inflammatory pseudotumor-like follicular dendritic cell tumor (IPT-like FDCT) is a rare, distinctive histological subtype of this low-grade malignant neoplasm, with consistent Epstein-Barr virus (EBV) association. The differential diagnosis with other fibro-inflammatory tumor proliferations, as inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT), may be challenging. In the present article, two cases of IPT-like FDCT of the spleen are presented, with a broad overview of the literature: one 77-year-old male and one 70-year-old female. A large immunohistochemical panel should be used for diagnosis, as no single specific and totally sensitive markers are available, including markers for CD21, CD23, CD35, CNA42, and clusterin. Individual cases may express one or more of these markers, so that all of them should be investigated. In situ hybridization for EBV is constantly positive. Immunostaining for ALK should be negative, as it is present in roughly half of the cases of IMT. This panel should be used in combination of clinical, laboratory, and topographic evidences. Importantly, inclusion of this lesion as a possible option in clinical and pathological investigation represents the basis for a correct diagnosis.

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“…Microscopically, the nodules show a variable admixture and sieve like arrangement of vascular spaces that represent an admixture of cells lining splenic sinusoids, capillaries and veins (4). The degree of circumscription of nodules by collagen and the quality of the intervening stroma (whether fibromyxoid, sclerotic or hyaline) may vary negative for CD34 unlike the mixed immune-expression of SaNT.…”

Section: Discussionmentioning

confidence: 99%

Sclerosing angiomatoid nodular transformation of the spleen: a new entity or a new name?

Agrawal¹,

Uppin²,

Bh³

et al. 2014

TJPATH

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Sclerosing angiomatoid nodular transformation of the splenic red pulp has been described quite recently; many of the lesions previously diagnosed as splenic exuberant granulation tissue, multinodular hemangioma, and inflammatory pseudotumor could actually belong to this category. The lesion has been well reported intermittently in the past, but new cases with still newer associations keep appearing from time to time. There are no known risk factors and no inciting triggers have been proven. We report two such cases-one of which has extensive extramedullary haematopoiesis; a feature that has never been reported earlier. Clinico-morphological and radiological features along with pathogenesis are discussed in detail.

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Is sclerosing angiomatoid nodular transformation (SANT) of the splenic red pulp identical to inflammatory pseudotumour? Report of 16 cases

Cited by 77 publications

References 8 publications

Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma

Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma

Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia

Sclerosing angiomatoid nodular transformation of the spleen: a new entity or a new name?

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