Littoral cell angioma with severe thrombocytopenia.
Littoral cell angioma (LCA) is a recently described splenic vascular tumor. We present a new case in a 62-year-old woman with severe thrombocytopenia and mild bleeding diathesis, but without palpable splenomegaly. Abdominal ultrasound and magnetic resonance showed multiple nodular images, suggesting splenic hemangiomas. A platelet kinetic study revealed a very short platelet survival. As the spleen was the site of platelet destruction, splenectomy was carried out. Histopathological and immunohistochemical data allowed a final diagnosis of LCA. Following splenectomy, the patient showed a transitory normalization of the platelet counts. Thrombocytopenia then reappeared but was moderate, without hemorrhagic diathesis. A second platelet kinetic study, performed 16 months post-splenectomy, showed hepatic platelet destruction. However, there were no macroscopic hepatic lesions in a second abdominal magnetic resonance study. This case illustrates the difficulties involved in determining the etiology of many peripheral thrombocytopenias.
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Departament d'Hematologia, Hospital de la Santa Creu i Sant Pau, Avgda. S. Antoni Ma Claret 167, 08025-Barcelona, Spain.
Lerma
E
E
Fumanal
V
V
Palmer
J
J
Roca
M
M
Domingo-Albós
A
A
Pujol-Moix
N
N
D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000150:complications* / Q000473:pathology*; D013921:Thrombocytopenia / Q000150:complications* / Q000209:etiology; D013997:Time Factors