Specimen fine-needle aspiration cytology of littoral cell angioma with histologic and immunohistochemical confirmation

We performed a specimen fine-needle aspiration biopsy (FNAB) of a littoral cell angioma (LCA) from a 33-yr-old male who underwent elective splenectomy due to thrombocytopenia secondary to Wiscott-Aldrich syndrome. Gross exami nation revealed a 420-g, diffusely enlarged spleen which contained two mode rately well-circumscribed, soft brown lesions measuring 0.3 and 1.0 cm, res pectively Benchtop aspiration of the lesions following splenectomy yielded a cellular sample composed predominantly of dispersed single cells, which r anged from columnar to spindle to circariform in shape. Nuclei were round t o oval with even chromatin, and many contained single longitudinal grooves. A majority of the cells contained abundant, granular hemosiderin pigment, a key cytologic feature. I,Immunohistochemical staining revealed reactivity for antibodies to CD68 and factor VIII-related antigen with no reactivity for S-100 protein and CD8. Littoral cell angioma must be differentiated fro m splenic hamartoma, hemangioma, angiosarcoma, littoral cell angiosarcoma, and epithelioid and spindle cell hemangioendothelioma. A combination of cyt ologic features and immunohistochemical results should enable an accurate d iagnosis. Diagn. Cytopathol. 2000;22:39-44. (C) 2000 Wiley-Liss, Inc.