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International Journal of Surgical Pathology
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What's this?

Sclerosing Angiomatoid Nodular Transformation (SANT) of the Spleen: A Report of 3 Cases

Aashiyana F. Koreishi, MD

Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, feldstej{at}mskcc.org

Adam J. Saenz, MD

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia

Stephen E. Fleming, MD

Department of Radiology Memorial Sloan-Kettering Cancer Center, New York

Julie Teruya-Feldstein, MD

Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia

The authors describe 3 cases of sclerosing angiomatoid nodular transformation (SANT) of the spleen diagnosed at Memorial Sloan-Kettering Cancer Center within a 1-year period (July 2008 to June 2009). All patients were female, older than 50, with lesions ranging in size from 2 to 4 cm. All were alive and well after splenectomy. All the cases showed characteristic histological and immunophenotypical findings as previously described in the literature, including scattered IgG4positive plasma cells in the fibrosclerotic stroma. Of the 3 patients, 2 had a history of carcinoma, and metastasis was of concern, but a PET scan in one of these patients showed minimal to absent FDG activity suggesting that this process was of a benign indolent nature. However, in 1 patient, a PET scan revealed positive FDG activity, heightening clinical concern for malignancy.

Key Words: sclerosing angiomatoid nodular transformation • SANT • hamartoma • hemangioma • spleen • PET scan

This version was published on October 1, 2009

International Journal of Surgical Pathology, Vol. 17, No. 5, 384-389 (2009)
DOI: 10.1177/1066896909342568
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