Littoral Cell Angioma of Spleen: a Rare but Important Differential for Splenic Lesions

Abstract

Littoral cell angioma (LCA) is a rare splenic vascular neoplasm that arises from the cells lining the red pulp sinuses. Many recent reports have described this as a malignant tumour with congenital and immunological associations. Majority of patients remain asymptomatic though few present with variable symptoms. We present the case of a 65-year-old male with multiple splenic space occupying lesions associated with recurrent fever and weight loss. Computed tomography (CT) scans revealed splenomegaly with multiple hypoattenuating lesions. Further investigative workup failed to give the definitive diagnosis. Patient underwent laparoscopic splenectomy with an intent of establishing diagnosis and potential cure. Postoperative histological and immunohistochemical studies confirmed the diagnosis of LCA. Only a few case reports have been published as inconsistent results. Based on our experience of this case, we reviewed the available literature about the clinical, radiological and pathological features of this uncommon disease.