Splenic littoral cell angioma with severe hypoproteinemia: a rare case report of 2 years follow-up

Splenic littoral cell angioma (LCA) is a comparatively rare vascular neoplasm of the spleen. LCA always presents with thrombocytopenia, fever, weight loss, and abdominal pain, and may also involve splenic rupture. To our knowledge, however, splenic LCA is rarely accompanied by severe hypoproteinemia. This report describes a 36-year-old woman with multiple splenic LCA, accompanied by severe hypoproteinemia. Computed tomography (CT) and magnetic resonance imaging (MRI) showed multiple hemangiomas in the spleen. Splenectomy was performed. Postoperative histological and immunohistochemical examinations showed that the lesion was an LCA. Diagnosing splenic LCA is difficult, not only because it is infrequent but because of its nonspecific clinical presentation and variable radiological findings. The findings in this patient show the importance of a very rare, not fully understood cause of severe hypoproteinemia.