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Distinctive PET/CT features of splenic SANT
Yu-Min Feng1, Ying Chieh Huang, Chi-Wen Tu
1From the *Departments of Medicine, †Emergency Medicine, ‡Surgery, §Radiology and ¶Nuclear Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi; ∥Department of Life Science, National Chung Cheng University, Chia-Yi, Taiwan;**College of Health Sciences, Chang Jung Christian University, Tainan; ††Center of General Education, Chia Nan University of Pharmacy & Science, Tainan; and ‡‡Medical Center and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Sclerosing angiomatoid nodular transformation (SANT) is a rare splenic condition. This case highlights its unique "prunes on bread" PET/CT appearance, aiding diagnosis and differentiating it from malignancy.
Area of Science:
- Vascular pathology
- Abdominal imaging
- Surgical pathology
Background:
- Splenic lesions require accurate diagnosis to differentiate benign from malignant conditions.
- Sclerosing angiomatoid nodular transformation (SANT) is an uncommon vascular tumor of the spleen.
Observation:
- A 44-year-old woman presented with epigastralgia and a 6 cm splenic lesion.
- Imaging revealed multiple, FDG-avid splenic nodules with a characteristic "prunes on bread" appearance on PET/CT.
- PET/CT showed central hypometabolism and peripheral hypermetabolism within the nodules.
Findings:
- Histopathology confirmed multiple nodules with an angiomatoid appearance.
- Immunohistochemistry showed CD31 and CD34 positivity, consistent with vascular origin.
- Absence of Human Herpesvirus 8 (HHV-8) ruled out other differential diagnoses.
Implications:
- This case emphasizes the diagnostic utility of PET/CT in identifying SANT.
- Recognizing the "prunes on bread" sign can prevent misdiagnosis of splenic malignancy.
- SANT should be considered in the differential diagnosis of splenic nodules with specific imaging features.
