Sclerosing angiomatoid nodular transformation of the spleen: multimodality imaging features and literature review.

OBJECTIVE: The purpose of this study was to evaluate the CT and MRI findings, clinicopathologic features, and differential diagnosis of Sclerosing angiomatoid nodular transformation (SANT). METHODS AND MATERIALS: Seven men and seven women with pathological diagnoses of SANT were included in this retrospect study. Patients underwent at least one radiological examination before surgery. The number, shape, margin, size, attenuation, signal intensity, homogeneity, and enhancing pattern of the lesion were evaluated by two abdominal radiologists independently. Immunohistochemistry reports were available for 11 patients. The immunoreactivity to the vascular markers CD8, CD31, and CD34 was assessed. RESULTS: The 14 SANT patients (7 men, 7 women; mean age, 43.5 years; age range, 24-56 years) presented with a single lesion and showed no specific clinical symptoms. Among 14 patients, 12 patients underwent MR scan, 5 patients underwent CT scan and 3 patients underwent PET-CT. On CT, all 5 lesions showed hypodensity on non-contrast images and spoke-wheel enhancing pattern after contrast administration, and calcification was observed. On T2WI, 10 cases(83.3%)showed hypointensity and 2 cases (16.7%) showed hyperintensity with central hypointensity. On T1WI, 10 cases (83.3%) were isointense and 2 cases (16.7%) were slightly hypointense. 10 cases (83.3%) showed hypointensity on DWI and 2 cases (16.7%) showed slightly hyperintensity on DWI. After contrast administration, all 12 lesions showed progressive enhancement. 18 F-fluorodeoxyglucose (FDG) uptake in the tumor was seen in all three cases that underwent PET-CT. The maximum standardized uptake value (SUVmax) was 4.5, 5.1, and 3.8 respectively. RESULTS: Apart from the progressive spoke-wheel enhancing pattern, DWI and ADC findings will add value to the diagnosis of SANT.

Treatment Options for Multinucleate Cell Angiohistiocytoma: A Case Series and Review of the Literature.

BACKGROUND: Multinucleate cell angiohistiocytoma (MCAH) is an unusual fibrohistiocytic proliferation in the dermis with vascular hyperplasia. Numerous clinicopathological studies of MCAH have been published, but little has been written in relation to treatment. OBJECTIVES: The aim of the present study is to review the therapeutical approaches for MCAH in the literature and to report the results of the different therapies followed at our institution. METHODS: A literature review was conducted including all MCAH published cases that followed any therapy. Search terms included "multinucleate cell angiohistiocytoma" or "MCAH" and "treatment" or "therapy". Also, all cases of MCAH treated at our institution from 2010 to 2020 are reported. RESULTS: The literature search revealed 16 cases of MCAH treated with any of the therapeutic options. At our institution, 9 patients have been treated of MCAH between 2010 and 2020. Over 75% of them were female, and the median age was 56 years (range 47-73). More than 50% had lesions on the dorsum of the hands. Surgical excision was indicated in 2 patients, ablative CO2 laser was used in 1 patient and the 6 remaining ones followed vascular-targeted therapies (PDL and IPL). A satisfactory cosmetic result was achieved in all of them. CONCLUSIONS: We propose PDL therapy as a first-line treatment for MCAH since it achieves satisfactory esthetic results, while being well-tolerated. Selecting those amenable patients according to morphologic characteristics may be useful to avoid unsuccessful therapies. In MCAH with predominant fibrous stroma, surgery or CO2 laser may be the best option.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: review of the literature.

We present a sclerosing angiomatoid nodular transformation (SANT) case report in a 60 year-old-woman. SANT is an extremely rare benign disease of the spleen that it is radiologically similar to malignant tumors, and clinically difficult to differentiate from other splenic diseases. Splenectomy is both diagnostic and therapeutic in symptomatic cases. The analysis of the resected spleen is necessary to achieve the final diagnosis of SANT.

Angiomatoid fibrous histiocytoma in the spinal canal of T3-T4: a case report and literature review.

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumour that occurs in the superficial tissue of extremities of children and young adults. A painless mass in the deep dermis and subcutaneous tissue is the main clinical manifestation. AFH also occurs infrequently in the central nervous system and is relatively common in the cranium. However, spinal canal AFH has not been described yet. We report a rare case of AFH in the cervical canal of a 20-year-old male patient. Microsurgical gross total resection of the tumour was performed, and the diagnosis was confirmed by postoperative pathology. To our knowledge, this is the first case of AFH in the spinal canal.

Efficacy of a Fractionated 1540-nm Erbium Glass Laser in the Treatment of Dermatofibromas.

BACKGROUND: Treatment of dermatofibromas, beyond surgical excision, has remained inadequate and elusive. Nonsurgical treatment options are desired by both patients and physicians. Erbium glass lasers are known for targeting and remodeling the dermis but have not yet been studied for the treatment of dermatofibromas. OBJECTIVE: To evaluate the efficacy and safety of the fractional 1540-nm erbium glass laser for treatment of dermatofibromas. METHODS: Thirty-five patients representing 44 dermatofibromas completed 2 consecutive monthly treatments with a non-ablative, fractional 1540-nm erbium glass laser and were evaluated at 4, 8, and 12 weeks after the initial treatment. Dermatofibromas were evaluated using patient surveys given before and after the treatments. RESULTS: By week 4, patients reported improvement in color and texture of the dermatofibromas. These improvements were durable through week 12. No complications were reported. CONCLUSIONS: This study demonstrates that the fractional 1540-nm erbium glass laser may be used to improve the color and texture of dermatofibromas and achieve positive patient reported outcomes after only 2 treatments. J Drugs Dermatol. 2022;21(11):1201-1205. doi:10.36849/JDD.6287.

Benign fibrous histiocytoma of the medial rectus muscle.

We report the case of a healthy 17-year-old girl who underwent surgery for excision of a painless, rapidly enlarging subconjunctival mass. The mass was found to be tightly adherent to the medial rectus muscle of the left eye, requiring extensive dissection. Histopathology revealed a mass of bland and foamy spindle cells in a storiform pattern that was positive for CD68, PGM1, and factor XIIIA and negative for S-100. The clinical and histopathologic findings are consistent with benign fibrous histiocytoma.

[A Case of Sclerosing Angiomatoid Nodular Transformation Resected for Suspected Relapse of Diffuse Large B-cell Lymphoma].

We report a case of sclerosing angiomatoid nodular transformation(SANT)5 years after remission of diffuse large B-cell lymphoma(DLBCL). A 64-year-old woman was diagnosed a nodular mass at the spleen by a contrast-enhanced CT scan 5 years after the relief for DLBCL. The mass showed accumulation of FDG. Because the possibility of the recurrence of malignant lymphoma could not be ruled out, laparoscopic splenectomy was performed for diagnosis and treatment. Immunohistologically, the resected mass revealed 3 different vascular components pattern(CD31, CD34 and CD8), so we diagnosed SANT. It is difficult to distinguish from malignant lymphoma or cancer even with various examination, so laparoscopic splenectomy is useful for diagnosis and treatment.

Benign fibrous histiocytoma of the oral and maxillofacial region: A systematic review.

OBJECTIVE: The aim of the present study was to carry out a systematic review of available data regarding case reports and case series of oral and maxillofacial benign fibrous histiocytoma (BFH). STUDY DESIGN: A search strategy was performed using the PubMed, Web of Science, Scopus, and EMBASE electronic databases. RESULTS: Male individuals (56.89%) were more affected, with a mean age of 34.55 ± 20 years. The buccal mucosa (20.33%) represented the most common site, with the clinical presentation of a painless (86.95%) nodule (98.03%). The clinical hypothesis of a fibroma was reported in most cases (31.57%). Radiographic presentation of intraosseous lesions showed multilocular radiolucent images (55.55%). Regarding the histopathologic features, the biphasic population of fibroblastic and histiocytic cells was seen in 21 cases (39.62%), and a spindle-shaped fibroblastic cell population organized into a storiform pattern was observed in 25 cases (47.16%). CD68 (n = 26) and vimentin (n = 25) showed immunoreactivity in all BFH cases in which they were used. All cases were treated with a surgical resection, and 8.10% recurred. CONCLUSIONS: The current systematic review demonstrated that BFH represents a rare lesion that mainly affects the buccal mucosa of male individuals, and the treatment is mainly surgical with a good prognosis.

Sclerosing angiomatoid nodular transformation of the spleen: a case report.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is an uncommon primary benign condition with specific histopathological characteristics. The majority of the patients are usually asymptomatic and present for treatment after an incidental finding on a routine abdominal imaging. The differential diagnosis includes other benign tumours, as well as primary malignancy or metastases of unknown origin. We report a 55-year-old woman who was presented to the surgical team of our hospital for splenectomy after the investigation of an incidental splenic lesion led to the diagnosis of SANT. The pathology report of the specimen repeated the initial diagnosis. The patient has not yet presented any complication or recurrence of the disease 8 months after the operation. From such infrequent cases, the most valuable conclusion which can be yielded is that the more the number of patients reported, the more the knowledge about the disease is broadened.