Clinical Information: 49 year old female with incidental finding of splenic mass. ?lymphoma
What is your diagnosis?
Discussion and answer
Diagnosis: multinodular hemangioma
On low power examination, the lesion has a multinodular appearance that simulates the appearance of granulomatous inflammation. The individual vascular nodules have a vaguely lobulated architecture, and are surrounded by a hyaline shell that stain strongly factor VIII related Antigen (not shown). The vascular areas within the nodules are markedly cellular and composed of an admixture of CD34 positive plump endothelial cells and CD68 positive histiocytes. These lesions are almost always solitary and the evolution is benign. The adjacent splenic tissue shows some congestion of the red pulp but is otherwise unremarkable.