摘要
目的探讨脾硬化性血管瘤样结节性转化(SANT)的临床病理特征及相关鉴别诊断。方法收集7例SANT病例的临床资料和病理切片,选取典型蜡块进行相关标记物的免疫组织化学染色,检测主要指标包括SMA、CD34、CD31、CD4、CD8、CD68、IgG4、IgG等。结果 7例中3例为女性,4例为男性;年龄从28岁到43岁不等,平均年龄37岁;7例中4例为直接诊断为SANT,3例原诊断分别为脾脏错构瘤、脾炎性假瘤和结节性血管瘤,复查后更正为SANT;肿瘤大小从直径4.0cm到10.5cm不等,平均直径为6.3cm;组织学病变呈多结节状,结节周围广泛纤维化和玻璃样变;结节内呈血管瘤样病变,可表现为毛细血管瘤样构象或窦岸血管瘤样构象。免疫组织化学示结节内血管CD31恒定阳性,但CD34和CD8表达有所差异。结论 SANT是一种罕见的脾脏原发的良性瘤样病变,具有特征性的组织学和免疫组织化学表现,应和脾脏原发的其他良恶性肿瘤进行鉴别。
Objective To investigate the clinicopathological features and differential diagnosis of sclerosing angiomatoid nodular transformation （SANT） of the spleen. Methods Clinical data of 7 cases of SANT were retrospectively ana- lyzed. Typical paraffin-embedded blocks were obtained and used for the immunohistochemical staining of CD34, CD31, SMA, CD68,CD4,CD8,IgG and IgG4. Results The study involved 3 females and 4 males with their age ranging from 28 to 43 years （mean：37 years）. Among the patients,4 were initially diagnosed with SANT, and 3 cases were mistaken for hamartoma,heman- gioma or inflammatory pseudotumor of the spleen on their first diagnosis. The tumor size ranged from 4.0 cm to 10.5 cm （mean：6.3 cm）. The typical histologic features were multiple well-circumscribed angiomatoid nodules showing plump endotheli- al cells and extravasated erythrocytes. The nodules were surrounded by a variable lymphoplasmacytic infiltrate, spindle cells,and collagenous stroma. The vascular nodules displayed a complex mixture of endothelial phenotypes resembling capillaries or splenic sinusoids. Immunohstochemistry staining showed that CD31 was positive in all the cases, but the expression of CD34 and CD8 varied with different subtypes. Conclusion SANT is a rare primary benign tumor-like lesion of the spleen;it has characteristic histopathological features and immunohistochemal profiles, and should be distinguished from other primary neoplasms of the spleen.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第1期99-102,共4页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
硬化性血管瘤样结节性转化
脾脏
sclerosing angiomatoid nodular transformation
spleen
