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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 investigate the clinical, pathological, diagnosis and treatment of splenic sclerosing hemangioma-like nodular transformation (SANT). Methods The clinical and pathological features, immunohistochemical expression and postoperative follow-up of two cases of SANT were analyzed and reviewed. Results The tumor showed multiple hemangioma-like granulomatous nodules under the microscope. The nodules were dense or mucoid fibrous connective tissue. The nodules showed oval, short fusiform, abundant cytoplasm, Can be seen branched and crack-like irregular capillaries, interstitial plasma cells, lymphocyte infiltration and erythrocyte extravasation. Cell morphology is mild, no atypia, mitosis is rare. Immunophenotype complex, no characteristic performance. 2 cases were treated with splenectomy. All cases were followed up for 6 months - no recurrence or metastasis was found in more than one year. Conclusions SANT is a rare benign proliferative disease with characteristic pathological changes. It is easily confused with malignant spleen in clinic and easily confused with inflammatory pseudotumor, wrong hook tumor and so on. The splenectomy is an effective treatment The prognosis is good.