Sclerosing angiomatoid nodular transformation of the spleen (SANT): Multimodality imaging appearance of five cases with radiology-pathology correlation

Objective: Sclerosing angiomatoid nodular transformation (SANT) is an extremely rare splenic lesion first reported in 2004, representing an unusual reaction of splenic red pulp to stromal inflammation or vascular injury. There are very few descriptions of the imaging appearance of SANT in the literature. We present five pathologically proven cases of SANT, with a description of the imaging appearance using multiple different modalities, as well as correlation with the histopathologic features of the lesion. Conclusion: While there are several imaging features of SANT which have been described in the literature, it is not routinely possible to make a prospective diagnosis based on the imaging features alone. Moreover, it may not be possible to exclude malignancy based on the imaging features, and splenectomy may be required in certain cases.