脾硬化性血管瘤样结节性转化6例临床病理分析  

Sclerosing angiomatoid nodular transformation of spleen: a clinicopathologic study of 6 cases

作　　者：颜红柱[1] 李维卿[1] 刘惠敏[1] 何金[1] 余宏宇[1] 

机构地区：[1]第二军医大学附属长征医院病理科,上海200003

出　　处：《诊断病理学杂志》2013年第10期593-595,599,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨脾硬化性血管瘤样结节性转化(SANT)的临床病理表现、诊断与鉴别诊断。方法对6例SANT的临床、组织病理学和免疫组化特征进行观察并文献复习。结果 SANT主要表现为局部有多个血管瘤样结节,结节周围可有增生的纤维组织包绕,结节中心为裂隙样、不规则的血管腔,内衬肥胖的内皮细胞,管腔周围可见梭形细胞和卵圆形细胞,结节之间亦可见密集的梭形细胞和卵圆形细胞,有淋巴细胞、浆细胞和组织细胞浸润。免疫组化:血管样腔隙内皮细胞显示3种不同的免疫组化表型CD34+/CD31+/CD8-、CD34-/CD31+/CD8+和CD34-/CD31+/CD8-,结节内梭形细胞CD31、SMA和CD68(+),结节间梭形细胞和卵圆细胞SMA和CD68(+)。结论 SANT是一种少见的脾良性病变,有特征性的临床病理表现,预后良好,尤其需要与脾的交界性或恶性肿瘤鉴别。Objective To study the clinicopathologic features, diagnosis and differential diagnosis of sclerosing angiomatoid nodular transformation （SANT） of the spleen. Methods Six cases of sclerosing angiomatoid nodular transformation of spleen were retrieved. The clinical data, pathologic characteristics and immunophenotype were studied. Results Sclerosing angiomatiod nodular transformation was characterized by multiple angiomatiod nodules in a fibrosclerotic stroma. The nodules were composed of slit-like, irregular-shaped slightly dilated vascular spaces lined plump endothelial cells and interspersed by a population of spindle or ovoid ceils. The internodular stroma was scattered with lymphocytes, plasma cells and histocytes. Immunohistochemistry revealed 3 distinct types of vessels in the angiomatoid nodules： CD34 ＋/CD31 ＋/CD8 -, CD34 -/CD31 ＋/CD8 ＋ and CD34 -/CD31 ＋/CD8 -. The spindle cells of the nodules showed staining for CD31, SMA and CD68. CD68 and SMA were positive in the spindle cells of the internodular area. Conclusion Sclerosing angiomatoid nodular transformation of spleen is a rarely benign and characteristic lesion, which should particularly be distinguished from borderline or malignant tumors of the spleen.

关 键 词：脾 硬化性血管瘤样结节性转化 临床病理 免疫组化 

分 类 号：R733.2[医药卫生—肿瘤]