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Abstract
Littoral- cell angioma (LCA) is a rare vascular tumor of the spleen. It was thought to be a benign, incidental lesion. However, many recent reports have described it to be a malignant lesion with congenital and immunologic associations. We report a case of LCA of the spleen, which has been infrequently communicated in the literature. A 41-year-old female patient was admitted to our hospital with a three-week history of weakness, weight loss, anorexia, and intermittent upper abdominal pain which improved slightly with antacid medication.Imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI), showed multiple lesions in the spleen. Laparoscopic splenectomy was performed.
Keywords: Littoral-cell angioma, red pulp, spleen
Introduction
Littoral-cell angioma (LCA) is a rare primary tumor of the spleen that was first described by Falk et al. in 1991.1 Two forms of LCA have been described; the more commonly encountered diffuse multiple nodular form as in our case and the rare solitary form.2 It originates from the specialized endothelial cells lining the sinus channels of the splenic red pulp, called "littoral cells". Clinically, a majority of the LCA described in the literature have been found to be benign in nature, but several reports have described malignancy in the LCA.3 Definite evaluation can only be done at pathology. We report a case of LCA in a patient who had symptoms of weakness and intermittent upper abdominal pain which improved slightly with antacid medication. The combination of CT and MRI showed multiple lesions in the spleen.
Case Report
A 41-year-old female patient was admitted to our hospital with a three-week history of weakness, weight loss, anorexia, and intermittent upper abdominal pain which improved slightly with antacid medication. Physical examination was normal. No splenomegaly was found. Results of routine laboratory tests were normal. An ulcerous lesion in the duodenum was detected gastroscopically. An enhanced CT scan of the abdomen showed multiple round, hypodense lesions in the spleen (Figure 1). Abdominal MRI revealed multiple splenic hypointense lesions (Figure 2). Our presumptive preoperative diagnosis was lymphoma or hemangioma. After appropriate preoperative vaccination for Streptococcus pneumoniae, Haemophilus influenzae B, and Neisseria meningitidis, laparoscopic splenectomy was performed. Gross examination...