Splenic littoral cell hemangioendothelioma in a patient with crohn's disease previously treated with immunomodulators and anti-TNF agents: A rare tumor linked to deep immunosuppression

Th e risk of malignancy in Crohn ’ s disease (CD) has been well described. Moreover, immunomodulators, uch as azathioprine (AZA) and 6-mercaptopurine (6-MP), and biological agents, such as infl iximab and adalimumab, may promote carcinogenesis ( 1 – 3 ). Splenic littoral cell tumors are recently described tumors of vascular origin composed of endothelial cells, with typical microscopic and immunohistochemical features of splenic sinus lining cells ( 4 ). Clinical findings are not specific, and outcome is unpredictable but usually benign, although a few cases with a malignant behavior have been reported ( 5,6 ). We report a 58-year-old Caucasian man with a long history of ileocolonic CD.