摘要
目的探讨脾脏硬化性血管瘤样结节性转化(SANT)的临床、病理、诊断与治疗。方法对2例SANT的临床、病理特征及免疫组化表达及术后随访情况进行分析并复习文献。结果显微镜下见肿物呈多个血管瘤样肉芽肿性结节,结节间为致密或黏液样变的纤维结缔组织,结节中瘤细胞呈卵圆形、短梭形,胞质丰富、可见分枝状及裂隙样不规则毛细血管,间质多量浆细胞、淋巴细胞浸润及红细胞外渗。细胞形态温和,无异型性,核分裂很少见。免疫表型复杂,无特征性表现。2例均行脾切除术治疗。术后随访6个月—1年余均无复发与转移。结论 SANT是一种罕见的具有特征性病理改变的良性增生性病变,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,脾切除术是有效的治疗方法,预后良好。
Objective To review the clinical manifestations,pathology,diagnosis,and therapy of sclerosing angiomatoid nodular transformation（SANT） of spleen.Methods The clinical manifestations,pathology,expression of immunohistochemistry,and the follow-up survey of 2 cases of SANT were analyzed,and the related literature was reviewed.Results The morphological features of SANT under microscope were as follows： Multiple angioloma-like granuloma nodules were observed.The nodules appeared as compact or mucoid-degenerated fibrous connective tissue,and tumour cells in the nodules were orbicular-ovate or short spindle-shaped with rich cytoplasm.Cladodromous or crack-like irregular capillary vessels were detected.There were numerous plasmocytes,lymphocytes,and erythrocytes in the interstitium.The cell morphology was mild with no-atypia,and nuclear division was rarely seen.There were no specific immunological characteristics.The two cases of SANT had no relapse or metastasis during the 6-months to 1-year follow-up after splenectomy.Conclusions SANT is an infrequent hyperplatic and benign lesion of spleen which has a remarkably pathologic characteristic appearance.However,it might be mistdiagnosed clinically as other diseases,such as splenic cancer,inflammatory pseudotumor,hamartoma,etc.The effective therapy of SANT is splenectomy which has a good prognosis.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2010年第11期1231-1233,共3页
China Journal of General Surgery
关键词
硬化性血管瘤样结节性转化
脾/诊断
硬化性血管瘤样结节性转化
脾/治疗
sclerosing angiomatoid nodular transformation
Spleen/diagnosis
sclerosing angiomatoid nodular transformation
Spleen/treatment
