06 May 2026
: Case report 
Splenic Marginal Zone Lymphoma as a Vascular-Appearing Mass in a Patient With Sustained Virologic Response to Hepatitis C Therapy
Challenging differential diagnosis, Rare disease
Xu Hao Isaac Tan ABCDEF 1*, Han Ning Yee
ABDE 2, Kah Wai Clarence Kwan ADE 3, Alvin Yong Hui Tan ADE 4, Shawn Kok ADE 1, Min On Tan ADE 1
DOI: 10.12659/AJCR.953179
Am J Case Rep 2026; 27:e953179
Table 1 Differential diagnosis of focal splenic lesions: classical features vs findings in current case.
| Entity | Classical imaging features | Findings in our case mimicking this diagnosis |
|---|---|---|
| Splenic hemangioma | Peripheral-to-central (centripetal) filling; typically stable in size []4 | Patient’s progressive peripheral-to-central enhancement mimicked this benign entity |
| Sclerosing angiomatoid nodular transformation (SANT) | “Spoke-wheel” enhancement with a central scar []5 | The patient’s progressive enhancement overlapped with the vascular patterns seen in SANT |
| Splenic angiosarcoma | Aggressive, ill-defined borders; heterogeneous enhancement and necrosis []8 | The rapid interval enlargement was the primary “red flag” mimicking this malignancy |
| Splenic marginal zone lymphoma | Diffuse splenomegaly []3 | Atypical presentation: presented as a focal mass with necrosis, mimicking the vascular lesions above |