case_images: PMC11822273_01
case_images: Splenic sclerosing angiomatoid nodular transformation in an 8-year-old patient.. A. US of the spleen. The lesion shows both peripheral (arrows) and central (arrowheads) vascularity on color Doppler US (right).. B. MRI of the upper abdomen. The mass appears isointense on the T1-weighted image (1st), as central hypointense areas with hyperintense radiations (arrows) on T2-weighted image (2nd), and as progressive centripetal enhancement with central spoke-wheel pattern on arterial (3rd), portal (4th), and venous phases (5th).. C. Contrasted enhanced CT performed before embolization and operation. Precontrast CT (1st) shows slightly enlarged size of the isoatteunated mass without a calcification (arrows). Contrast enhanced CT images (2nd: arterial, 3rd: portal, 4th: delay phase) reveal progressively delayed enhancement with multiple peripheral enhancing radiating lines (arrows), demonstrating spoke-wheel pattern.. D. Photograph of gross pathologic specimen. The splenic mass consists of multiple nodular lesions, exhibiting hemorrhagic and sponge-like textures. No distinct necrosis or cystic changes were visible, and the adjacent splenic parenchyma appeared unremarkable.. E. Histopathological findings of the splenic mass. The specimen shows multiple nodules of various sizes, surrounded by faint sclerotic stromal bands (left upper). The nodules comprise complex vascular structures infiltrated by inflammatory cells. The endothelial cells lack obvious pleomorphism and mitotic activity (right upper). Immunohistochemistry staining shows all vascular structures exhibit immunoreactivity for CD31 (left lower). Some vasculatures are positive for CD8 (middle lower) and CD34 (right lower), corresponding to sinusoidal vessels and capillaries, respectively.. H&E = hematoxylin and eosin, HU = Hounsfield unit
case_images: jksr-86-191-g001.jpg
case_images: PMC11822273_01_jksr-86-191-g001.jpg
case_images: F1
case_images: Color Doppler US revealed peripheral vascularity around the tumor and central vascularity at its core (Fig. 1A). After intravenous contrast injection, the lesion exhibited progressive centripetal enhancement with multiple peripheral-enhancing radiating lines, forming a central spoke-wheel pattern (Fig. 1B). Internal necrosis or calcification was not observed (Fig. 1C). Macroscopic examination of the resected spleen revealed a splenic mass consisting of multiple nodular lesions with hemorrhagic and sponge-like textures (Fig. 1D). All vascular structures showed immunoreactivity for CD31, and some vasculature was positive for CD8 and CD34, corresponding to sinusoidal vessels and capillaries, respectively (Fig. 1E).