Splenic hemangioma-report of three pediatric cases with pathologic correlation

Abstract

Splenic hemangioma is a very rare neoplasm in children. We report three cases of splenic hemangioma, two of solitary hemangioma and one of hemangiomatosis. Two patients had hematologic disorders related to hemangioma. Imaging findings of this entity are presented and discussed with emphasis on pathologic correlation.

Littoral cell angioma of the spleen: US and MR imaging findings

“…This presents nonspecific US findings. Splenic hemangiomatosis usually shows a heterogeneous echogenicity with both hypoechogenic and hyperechogenic lesions [7,8]. Hemangiomas usually present a hypointense signal on unhenhanced T1-weighted MR images and a hyperintense signal on T2-weighted MR images, but this finding is also nonspecific [8,9].…”

Antiangiogenic therapy for a large splenic hemangioma

“…Pediatric cases of SH are rare, with fewer than 20 cases previously reported [2,6]. This vascular lesion is detected in adults more frequently, usually during the third to fifth decade of life, or at autopsy [3,7].…”

“…The majority of solid visceral hemangiomas are thought to be resistant to antiangiogenic or steroid treatment, therefore either expectant observation or surgery has been recommended [2]. We present a case in which a large splenic hemangioma regressed with antiangiogenic therapy using glucocorticoids, avoiding a splenectomy.…”

“…This lesion is even less common in infants and young children [2]. The patients are often asymptomatic, with many diagnoses made at autopsy.…”

Diffuse hemangiolymphangiomatosis in an infant

“…The differential diagnosis of diffuse interstitial pulmonary disease with splenomegaly in childhood encompasses other vascular diseases (lymphangiectasis, lymphangioleiomyomatosis, hemangioendothelioma, angiosarcoma, and pulmonary venoocclusive disease), infections, connective tissue diseases, cystic ®brosis, benign disorders such as histiocytosis, and malignancies such as leukemia or lymphomas [4,11,22]. If an interstitial pulmonary disease is accompanied by thrombocytopenia, anemia, and consumptive coagulopathy or other organ involvement, angiomatosis should be included in the differential diagnosis.…”