脾脏硬化性血管瘤样结节性转化1例临床病理观察并文献复习  

Sclerosing angiomatoid nodular transformation of spleen:a report of one case

作　　者：张晓玲[1] 郭效忠[1] 王秀荣[1] 苗玉[1] 邢荣格[1] 

机构地区：[1]沧州市中心医院病理科,河北沧州061001

出　　处：《现代肿瘤医学》2012年第8期1690-1692,共3页Journal of Modern Oncology

摘　　要：目的:报道1例少见的脾硬化性血管瘤样结节性转化(SANT),以提高对该病变的认识。方法:对1例SANT的临床、病理特征、免疫组化表达及术后随访情况进行分析并复习文献。结果:脾SANT具有众多由环靶状纤维组织围绕的肉芽肿样结节,伴有结节间不同程度硬化的间质。肉芽肿样结节内细胞呈卵圆形、短梭形,胞质相对丰富,部分细胞胞质内可形成含红细胞的腔隙,细胞间还穿插有衬覆肥胖内皮细胞的枝芽状毛细血管及相对扩张的窦隙样血管腔隙。免疫组化显示结节内不同血管样结构有3种不同的免疫组化表达。结论:SANT是脾具有特征性改变的一种良性病变,临床上易与脾脏恶性肿瘤混淆,病理上易与炎性假瘤、错钩瘤等混淆,诊断依靠病理组织学表现及免疫组化特点。行脾切除术可治愈,预后良好。Objective ：To report 1 case of sclerosing angiomatoid nodular transformation（SANT） of spleen. Meth- ods： The clinical manifestations, pathology, expression of immunohistochemistry, and the follow up of 1 case of SANT was analyzed, and the related literature was reviewed. Results ： The morphological features of SANTs were as follows ： multiple nodules in a granuloma - like appearance were surrounded by a prominent shell of concentrically deposited fi- bers, and in variably fibrosclerotic stroma. There were spindly or ovoid cells in the nodules which had plenty of cyto- plasm and indistinct cell borders. Some of them had vascular spaces in cytoplasm and could hold red cells in it. Fur- thermore, there were variable shapes of vascular spaces lined by plump endothelial cells interspersed in nodules. Im- munostaining revealed there were 3 distinct types of vessels in the nodule. Conclusion： SANT is a benign lesion of spleen which had a remarkably characteristic appearance. However there are few literatures about it in the past and it might be mistaken as other diseases of spleen such as inflammatory pseudotumor, hamatoma or hemangioma. The di- agnosis counts on the pathologic and inmunohistochemical findings. It could be cured by splenectomy with a favoura- ble prognosis.

关 键 词：脾 硬化性血管瘤样结节性转化 免疫组化 

分 类 号：R733.2[医药卫生—肿瘤]