摘要
目的报道2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2例SANT的临床、病理特征及免疫组化表达进行详细的形态学观察并复习相关文献。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;此外,结节内梭形、卵圆形细胞CD31、CD68和SMA呈不同程度(+),而CD21、S-100、CD1和EMA均(-);仅结节周边细胞F8(+),SMA结节间及结节周边纤维SMA均(+)。结论SANT是脾具有特征性改变的一种良性病变。过去常被归入脾炎性假瘤、错构瘤或血管瘤等。
Objective To report 2 cases of sclerosing angiomatoid nodular transformation of spleen to help us recognize it. Methods The clinical and pathological features with immunostaining of this disease were described in detail, and related literatures were 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 fibers, and in variably fibrosclerotic stroma. There were spindly or ovoid cells in the nodules which had plenty of cytoplasm and indistinct cell borders. Some of them had vascular spaces in cytoplasm and could hold red cells in it. Furthermore, there were variable shapes of vascular spaces lined by plump endothelial cells interspersed in nodules. Immunostaining revealed there were 3 distinct types of vessels in the nodule, and the cells with spindle or ovoid shape in the nodules showed variable staining for CD31, CD68, and SMA, but negative for CD21, S100, CDla or EMA. F8 was positive in the peripheral cells of nodules and the fibers in perinodules and the internodular stroma were positive for SMA. Conclusions 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, To highlight this lesion can help us to distinguish it from other angiomatoid diseases of the spleen.
出处
《诊断病理学杂志》
CSCD
2008年第5期378-381,共4页
Chinese Journal of Diagnostic Pathology
关键词
脾
硬化性血管瘤样结节性转化
多结节性血管瘤
Spleen
Sclerosing angiomatoid nodular transformation
Multinodular hemangioma
