title: Sclerosing angiomatoid nodular transformation of the spleen: CT and MRI features with pathologic correlation.
abstract: OBJECTIVE
  The objective of this study was to describe the CT and MRI features of sclerosing angiomatoid nodular transformation of the spleen with pathologic correlation.
  
  
  METHODS
  Nine patients with surgically resected and pathologically confirmed sclerosing angiomatoid nodular transformation were included in the study. Clinical history was reviewed to determine patient demographics and symptoms at presentation. Gross pathologic, histologic, and immunohistochemical findings were recorded. CT (n = 9) and MRI (n = 4) examinations were evaluated for lesion shape and margins, intrinsic characteristics, and enhancement pattern.
  
  
  RESULTS
  Patients included were six women and three men, with a mean age of 41.2 years. Pathologic features of sclerosing angiomatoid nodular transformation included multiple angiomatous nodules in a radiating pattern with a central stellate fibrous scar and evidence of hemosiderin deposition. On imaging, the lesions were solitary and round, 78% having a lobulated margin. They were heterogeneously hypoenhancing during the arterial and portal venous phases of contrast-enhanced CT or MRI, with peripheral enhancing radiating lines in 88% of lesions. They showed progressive enhancement and were isoenhancing or hyperenhancing in the delayed phase. A hypoenhancing central scar was shown on imaging in 22% of lesions. All lesions were hypointense on T2-weighted images.
  
  
  CONCLUSIONS
  Sclerosing angiomatoid nodular transformation shows characteristic CT and MRI findings reflecting the underlying pathology. Typical features are a solitary, round, lobulated mass with early peripheral enhancing radiating lines and progressive enhancement of the angiomatous nodules; delayed enhancement of the fibrous tissue; and hypo-intense T2 signal intensity from hemosiderin deposition.
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Lewis
authors.forename: Grant E
authors.initials: GE
authors.lastname: Lattin
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Nandedkar
authors.forename: Nadine S
authors.initials: NS
authors.lastname: Aguilera
mesh_terms: D000328:Adult; D000368:Aged; D000798:Angiomatosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012598:Sclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013154:Spleen / Q000473:pathology; D013156:Splenectomy; D013158:Splenic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media