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武警医学  2024, Vol. 35 Issue (7): 567-571    DOI:
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脾硬化性血管瘤样结节性转化的临床病理特征
于兰1, 丁会珍2, 高逸群3, 路平3, 张静4
100048 北京,解放军总医院第六医学中心:1.消化内科,3.病理科, 4.放射诊断科;2.100037 北京,解放军总医院第四医学中心病理科
Clinicopathological features of sclerosing angiomatoid nodular transformation
YU Lan1, DING Huizhen2, GAO Yiqun3, LU Ping3, ZHANG Jing4
1. Department of Gastroenterology, 3. Department of Pathology,4. Department of Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048,China;2. Department of Pathology, the Fourth Medical Center of PLA General Hospital, Beijing 100037, China

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摘要 目的 探讨脾硬化性血管瘤样结节性转化(SANT)的临床病理特征。方法 收集2016-09至2022-09解放军总医院第四、六医学中心SANT患者的临床资料,主要分析其临床病理特征,同时分析影像学特征、免疫组化等资料。结果 共7例,其中男5例,女2例,年龄32~49岁,平均42.3岁,大部分偶然发现;6例单发,最大径3.0~14.5 cm(平均7.4 cm);1例多发,最大者5.7 cm×5 cm×3.5 cm,最小者0.7 cm×0.6 cm×0.6 cm;镜下见多个由纤维包绕的血管瘤样结节,结节内血管成分复杂,呈脾窦样、毛细血管样或静脉样,血管内皮细胞的CD34、CD31、CD8表达有所差异。周围梭形细胞SMA表达灶状阳性。原位杂交EBER检测结果均为阴性。结论 SANT是一种少见的具有独特病理学特征的良性血管性病变,多无临床症状,易误诊,手术切除即可治愈,术后病理学形态和免疫组织化学染色是明确诊断的重要方法。
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关键词 脾脏脾硬化性血管瘤样结节性转化临床病理鉴别诊断    
AbstractObjective To investigate the clinicopathological features of sclerosing angiomatoid nodular transformation(SANT). Methods Clinical data of SANT patients in the Fourth and Sixth Medical Center of PLA General Hospital from 2016 to 2022 were collected, and the clinicopathological features, imaging features and immunohistochemical data were analyzed. Results A total of 7 cases were found, including 5 males and 2 females, aged 32-49 years with an average age of 42.3 years. Six cases were single, with a maximum diameter of 3.0-14.5 cm (average 7.4 cm), and 1 case was multiple, with a maximum diameter of 5.7 cm×5 cm×3.5 cm, with a minimum diameter of 0.7 cm×0.6 cm×0.6 cm. Microscopically, there were multiple hemangiomatous nodules surrounded by fibers. The vascular components in the nodules were complex, which were like splenic sinus, capillary or venous. The expressions of CD34, CD31, and CD8 in vascular endothelial cells were different. The SMA expression in peripheral spindle cells was focally positive. EBER detection results of in situ hybridization were negative. Conclusions SANT is a rare benign vascular lesion with unique pathological features, which has no clinical symptoms and is easy to be misdiagnosed. It can be cured by surgical resection. Postoperative pathological morphology and immunohistochemical staining are important methods for definite diagnosis.
Key wordsspleen    sclerosing angiomatoid nodular transformation    clinical pathology    differential diagnosis   
收稿日期: 2024-02-20     
ZTFLH: R733.3  
通讯作者: 张 静,E-mail:007zhangj@163.com   
作者简介: 于 兰,博士,副主任医师。
引用本文:   
于兰, 丁会珍, 高逸群, 路平, 张静. 脾硬化性血管瘤样结节性转化的临床病理特征[J]. 武警医学, 2024, 35(7): 567-571. YU Lan, DING Huizhen, GAO Yiqun, LU Ping, ZHANG Jing. Clinicopathological features of sclerosing angiomatoid nodular transformation. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(7): 567-571.
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