【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、诊断与鉴别诊断要点及治疗方法。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观察并复习相关文献。结果 2例SANT的临床表现无特异性。组织学镜下见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。免疫组化示结节内不同血管样结构有3种不同的表达,结节内梭形、卵圆形细胞CD31、CD68和SMA呈不同程度(+),而CD21、S-100和EMA均(-)。术后随访,患者未发现病变复发和转移。结论 SANT是脾具有特征性改变的一种良性病变,过去易与脾炎性假瘤、错构瘤或血管瘤等相混淆。行脾切除术可治愈,预后良好。更多还原

【Abstract】 Objective To investigate the clinicopathologic features,diagnosis,differential diagnosis and treatment of sclerosing angiomatoid nodular transformation(SANT).Methods The clinical and pathological features with immunostaining were described in detail in 2 cases of SANT,and related literatures were reviewed.Results There were no specific findings in the clinical manifestations in the 2 cases of SANT.The morphological features of SANTs were as follows: multiple nodules in 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,S-100,or EMA.No relapse or metastasis was found during the follow-up.Conclusions SANT is a benign lesion of spleen which has a remarkably characteristic appearance.To highlight this lesion can help us to distinguish it from other angiomatoid diseases of the spleen such as pseudotumor,hamatoma or hemangioma.It could be cured by splenectomy with a favourable prognosis.更多还原