Sclerosing angiomatoid nodular transformation of the spleen with thrombocytopenia

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign vascular disease of the spleen. We report the case of a patient with SANT with thrombocytopenia. To achieve recovery from thrombocytopenia, resection of this splenic tumor was required. The patient was a 74-year-old woman who was admitted to our hospital due to gradually decreasing platelet counts. Contrast-enhanced computed tomography showed a 66 x 62 mm solid tumor in the spleen. Regarding thrombocytopenia, drug-induced or hematologic disease was ruled out, and no other possible causes were identified besides this splenic tumor. She underwent laparoscopic splenectomy for diagnosis and improvement of thrombocytopenia. This splenic tumor macroscopically resembled an angiomatoid tumor. To distinguish the characteristics of intratumoral vascular components, immunohistochemical staining including CD34, CD8, CD31, and alpha-smooth muscle actin (SMA) was performed and finally this tumor was pathologically diagnosed as SANT. The patient's platelet counts returned to normal range after surgery. If a splenic tumor with thrombocytopenia is identified, SANT might be a differential diagnosis, although it is a rare benign vascular disease of the spleen and difficult to diagnose. For definitive diagnosis, extraction of the splenic specimen may be required.