DOI: 10.1148/radiol.2302030196
Littoral Cell Angioma of the Spleen: CT Features with Clinicopathologic Comparison1
Angela D. Levy, LTC, MC, USA,
Robert M. Abbott, MD and
Susan L. Abbondanzo, MD
1 From the Departments of Radiologic Pathology (A.D.L.) and Hematopathology Pathology (S.L.A.), Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306-6000; Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (A.D.L., R.M.A.); and Department of Radiology, University of Maryland School of Medicine, Baltimore (R.M.A.). Received February 5, 2003; revision requested April 23; revision received May 1; accepted June 23. Address correspondence to A.D.L. (e-mail: levya@afip.osd.mil).
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Figure 1a. Histopathologic features of littoral cell angioma. (a) Photomicrograph shows littoral cell angioma nodules (arrows) composed of multiple blood-filled spaces (*). There is compression of the normal surrounding splenic red pulp. (Hematoxylin-eosin stain; original magnification, x2.) (b) Photomicrograph shows vascular channel lined with flat endothelial cells. A papillary projection (arrow) extends into the channel that contains exfoliated cells. (Hematoxylin-eosin stain; original magnification, x40.)
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Figure 1b. Histopathologic features of littoral cell angioma. (a) Photomicrograph shows littoral cell angioma nodules (arrows) composed of multiple blood-filled spaces (*). There is compression of the normal surrounding splenic red pulp. (Hematoxylin-eosin stain; original magnification, x2.) (b) Photomicrograph shows vascular channel lined with flat endothelial cells. A papillary projection (arrow) extends into the channel that contains exfoliated cells. (Hematoxylin-eosin stain; original magnification, x40.)
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Figure 2. Patient 6. Littoral cell angioma in 84-year-old woman evaluated for anemia and thrombocytopenia. She had no physical complaints. Transverse contrast-enhanced early portal venous phase CT image shows numerous low-attenuating masses of various sizes throughout an enlarged spleen.
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Figure 3a. Patient 7. Littoral cell angioma in 74-year-old woman who presented with persistent rectal bleeding 2 weeks after undergoing colonoscopy. She also had cirrhosis secondary to nonalcoholic steatohepatitis. (a) Transverse contrast-enhanced late portal venous phase CT image shows several low-attenuating masses (arrows) in a normal-sized spleen. (b) Resected surgical specimen shows a hemorrhagic nodule (arrows) at the periphery of the spleen. The nodule contains small hemorrhagic cystic spaces (*).
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Figure 3b. Patient 7. Littoral cell angioma in 74-year-old woman who presented with persistent rectal bleeding 2 weeks after undergoing colonoscopy. She also had cirrhosis secondary to nonalcoholic steatohepatitis. (a) Transverse contrast-enhanced late portal venous phase CT image shows several low-attenuating masses (arrows) in a normal-sized spleen. (b) Resected surgical specimen shows a hemorrhagic nodule (arrows) at the periphery of the spleen. The nodule contains small hemorrhagic cystic spaces (*).
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Figure 4. Patient 4. Littoral cell angioma in 41-year-old man found to have thrombocytopenia while being evaluated for potential blood donation. Transverse contrast-enhanced early portal venous phase CT image shows multiple, large, partially confluent masses within an enlarged spleen. The masses have partial areas of heterogeneous high attenuation.
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Figure 5a. Patient 1. Littoral cell angioma in 55-year-old woman found to have splenomegaly at physical examination for evaluation of leg swelling. (a) Transverse contrast-enhanced early portal venous phase CT image shows multiple, partially confluent hypoattenuating masses in the spleen. (b) Transverse contrast-enhanced late portal venous phase CT image shows that the masses are homogeneously enhanced and have become imperceptible. (c) Resected surgical specimen shows the spleen to have a diffusely nodular cut surface.
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Figure 5b. Patient 1. Littoral cell angioma in 55-year-old woman found to have splenomegaly at physical examination for evaluation of leg swelling. (a) Transverse contrast-enhanced early portal venous phase CT image shows multiple, partially confluent hypoattenuating masses in the spleen. (b) Transverse contrast-enhanced late portal venous phase CT image shows that the masses are homogeneously enhanced and have become imperceptible. (c) Resected surgical specimen shows the spleen to have a diffusely nodular cut surface.
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Figure 5c. Patient 1. Littoral cell angioma in 55-year-old woman found to have splenomegaly at physical examination for evaluation of leg swelling. (a) Transverse contrast-enhanced early portal venous phase CT image shows multiple, partially confluent hypoattenuating masses in the spleen. (b) Transverse contrast-enhanced late portal venous phase CT image shows that the masses are homogeneously enhanced and have become imperceptible. (c) Resected surgical specimen shows the spleen to have a diffusely nodular cut surface.
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Copyright © 2004 by the Radiological Society of North America.
