Littoral cell angioma of the spleen diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration biopsy

Nagarajan, Priyadharsini; Cai, Gouping; Padda, Manmeet; Selbst, Megan; Kowalski, Diane; Proctor, Deborah D.; Chhieng, David C.; Aslanian, Harry R.; Harigopal, Malini

doi:10.1002/dc.21384

Cited by 11 publications

(20 citation statements)

References 77 publications

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“…Görg et al 16 reported 2 cases and reviewed 5 additional cases of littoral cell angioma in the literature; all cases were hyperechoic, and 6 (86%) were multiple lesions. However, in 20 cases of littoral cell angioma reported in the English literature, [3][4][5][6][7][8][9][10][11][12][17][18][19][20][21][22][23][24] 10 cases (50%) were hyperechoic, 10 (50%) were hypoechoic or isoechoic, and 12 (60%) were multiple lesions. In our study, 2 patients (29%) had multiple hyperechoic lesions, and 5 (71%) had solitary hypoechoic lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with littoral cell angioma frequently have thrombocytopenia; therefore, a careful assessment of their clotting function should be made before biopsy. 7,19,24 There was a limitation to our study based on the nature of retrospective studies. Sonographic examinations were performed with different equipment and by different sonographers over a 4-year period, and the equipment presets were different.…”

Section: Discussionmentioning

confidence: 99%

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Littoral Cell Angioma of the Spleen

Yunhua

Liu

Wang

et al. 2013

Journal of Ultrasound in Medicine

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Objectives The purpose of this study was to evaluate the sonographic and pathologic features of littoral cell angioma of the spleen in 7 patients. Methods The sonographic appearance in 7 cases of littoral cell angioma confirmed by surgical pathologic examination was retrospectively reviewed. All underwent color Doppler imaging. Two underwent contrast‐enhanced sonography. The sonographic appearance was compared with pathologic findings. Results Splenic lesions were solitary in 5 cases and multiple in 2 cases. The masses ranged from 10 to 64 mm in maximum diameter. Five hypoechoic and 2 hyperechoic lesions on grayscale sonography corresponded to few and multiple blood‐filled spaces on pathologic examination, respectively. Four hypovascular lesions, 1 hypervascular lesion, and the other 2 hypervascular lesions full of color flow signals on color Doppler imaging corresponded to few, several, and multiple arteries on pathologic examination. On contrast‐enhanced sonography, 1 hypervascular lesion full of color flow signals showed homogeneous hyperenhancement for 8 minutes during the arterial and parenchymal phases. One hypovascular lesion showed inhomogeneous isoenhancement transiently during the arterial phase and became hypoechoic later. Conclusions Littoral cell angioma is a primary vascular splenic neoplasm with variable features on grayscale sonography and color Doppler imaging as well as contrast‐enhanced sonography. The sonographic appearance of littoral cell angioma mainly depends on the type and number of tumor vessels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Littoral Cell Angioma of the Spleen

Yunhua

Liu

Wang

et al. 2013

Journal of Ultrasound in Medicine

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“…[12345678] LCA is a benign tumor composed of anastomosing vascular channels with papillary projections and cyst-like spaces lined by tall endothelial cells oftentimes showing hemophagocytosis. [123] Although diagnosis of LCA is confirmed by morphology and immunohistochemistry, fine needle aspiration of tumor can help limit the differential diagnosis before operation. [3] To our knowledge, there have been few reports with cytological description of LCA in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…[123] Although diagnosis of LCA is confirmed by morphology and immunohistochemistry, fine needle aspiration of tumor can help limit the differential diagnosis before operation. [3] To our knowledge, there have been few reports with cytological description of LCA in the literature. [1234] In this study, we discuss a case of LCA with scraping cytological findings and its differential diagnoses.…”

Section: Introductionmentioning

confidence: 99%

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Littoral cell angioma of the spleen: Cytological findings and review of the literature

Anbardar

Kumar

Forootan

2017

J Cytol

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Littoral cell angioma (LCA) is a unique lesion of the spleen that arises from the cells lining the venous sinuses of the splenic red pulp and shows the features of combined endothelial and histiocytic differentiation. Several cases of LCA have been reported in the literature; however, the cytological findings have been described for only a few cases. We report the case of an 11-year-old boy with anemia, epigastric abdominal pain, and splenomegaly. The splenic lesions showed anastomosing vascular channels with cyst-like spaces filled by many sloughed endothelial cells, which were positive for CD68 and CD31 and negative for CD34. Scraping cytology revealed isolated and clusters of three-dimensional bland looking, epithelioid foamy tumoral cells with low nuclear cytoplasmic ratio, which mostly contained intracytoplasmic hemosiderin pigment. Although the fine needle aspiration cytology of splenic lesions is uncommon and LCA is a rare splenic lesion, it must be noted in the differential diagnosis of any splenic vascular neoplasm.

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Endoscopic ultrasound guided fine‐needle aspiration of a splenic hemangioma with extramedullary hematopoiesis

Hudson

Murad

Kunkel

et al. 2011

Diagnostic Cytopathology

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Extramedullary hematopoiesis (EMH) is the production of mature blood elements outside of the bone marrow and can occur as a compensatory result of a marrow replacing process or from marrow space occupying lesions such as tumor or marrow fibrosis. EMH can also be induced by factors elicited by neoplasms, such as vascular endothelial growth factor (VEGF). Usually, EMH is a diffuse process most commonly observed in lymph nodes, liver, and spleen. Rarely, EMH can form a mass lesion. Although the spleen is a common site for diffuse EMH, it is a rare location for a mass forming EMH. Hemangiomas are the most common benign tumors of the spleen. A case of a discrete, 8 cm lesion was noted incidentally on CT scan in a 59-year-old man with no significant past medical history. Endoscopic ultrasound guided fine-needle aspiration (EUS FNA) biopsy was performed and cytologic examination revealed trilinear hematopoiesis, with the most distinctive elements being megakaryocytes and erythroid precursors. A diagnosis of EMH was made. On resection, the mass was a hemangioma with EMH. EUS guided FNA is a useful tool for diagnosing splenic masses. Awareness of EMH, both as a mass forming lesion and a feature associated with benign and malignant vascular lesions is important, especially in patients with hematologic malignancies or marrow replacing processes.

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Littoral cell angioma of the spleen diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration biopsy

Cited by 11 publications

References 77 publications

Littoral Cell Angioma of the Spleen

Littoral Cell Angioma of the Spleen

Littoral cell angioma of the spleen: Cytological findings and review of the literature

Endoscopic ultrasound guided fine‐needle aspiration of a splenic hemangioma with extramedullary hematopoiesis

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