Wednesday, October 24, 2012

Littoral Cell Angioma of the Spleen

  • rare, primary splenic neoplasm
    • littoral cells line the red pulp sinuses in the spleen
  • CECT: 
    • enlarged spleen with innumerable hypoattenuating masses
    • no calcifications
    • no lymphadenopathy
    • no hepatomegaly
  • US:
    • diffuse, coarse, heterogenous echotexture of the spleen
  • Differential diagnosis
    • neoplasms
      • hemangiomas - appear similar but rarely have diffuse involvement, may calcify
        • hemangiomatosis - diffuse splenic hemangioma with same enhancement pattern as hepatic hemangioma
      • lymphoma - look for extra-splenic lymphadenopathy
      • metastatic disease - ovary, breast, endometrium, melanoma
    • granulomatous disease
      • sarcoidosis - increased echogenicity of spleen, + adenopathy
      • TB - look for chest involvement
    • infection
      • disseminated fungal disease
      • septic emboli
      • Kaposi's sarcoma

Kinoshita LL, Yee J, and Nash SR. Littoral cell angioma of the spleen: imaging features. AJR Am J Roentgenol 2000;174(2):467-9.
Levy AD, Abbott AM, and Abbondanzo SL. Littoral cell angioma of the spleen: CT features with clinicopathologic comparison. Radiology 2004;230:485-90.

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