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Case report
Sclerosing angiomatoid nodular transformation of the spleen: unusual case presentation in an intravenous drug user
  1. Carlos Sánchez Belmar1,
  2. Alexandra White2,
  3. Mudassar Majeed3 and
  4. Henry Paul Redmond4
  1. 1Department of General Surgery, Mallow General Hospital, Mallow, Ireland
  2. 2Department of Cardiothoracic Surgery, Galway University Hospital, Galway, Ireland
  3. 3Department of Breast and Endocrine Surgery, Cork University Hospital Group, Cork, Ireland
  4. 4Department of General Surgery, Cork University Hospital Group, Cork, Ireland
  1. Correspondence to Dr Alexandra White; ali_white5{at}hotmail.com

Abstract

An unusual presentation of sclerosing angiomatoid nodular transformation in a 42-year-old man who was admitted with jaundice, deranged liver function tests and subsequently diagnosed with acute hepatitis C infection in the context of recent intravenous drug use. During his admission, he had an ultrasound of the abdomen followed by a CT thorax, abdomen and pelvis which showed splenomegaly and a large splenic lower pole mass that was hypoechoic and concerning for lymphoma. A bone marrow biopsy showed no evidence of lymphoma and an ultrasound-guided biopsy of the splenic mass suggested unusual features with vascular proliferation, either neoplastic or reactive, with no evidence of lymphoma or high-grade sarcoma. Given the concern for malignancy, an open splenectomy was required to determine the nature of the lesion with histologic findings consistent with a non-neoplastic benign vascular lesion favouring sclerosing angiomatoid nodular transformation.

  • liver disease
  • hepatitis C
  • general surgery

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Footnotes

  • Contributors CSB: collection of data and images, writing and reporting of initial draft and subsequent drafts with corrections and obtaining patient consent. AW: literature review, guidance/planning and conduct of paper, editing and proof reading of final draft, editing of images and submission of paper. MM: general supervision and planning, proof reading of drafts, guidance and input from theatre, operation details and guidance for acquisition of patient consent. HPR: head of department, general supervision and planning, final review of article and conception/initial idea to write report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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