彩色多普勒超声诊断脾脏硬化性血管瘤样结节性转化1例

目的 脾脏硬化性血管瘤样结节性转化的超声表现及诊断思路,提高脾脏肿瘤的术前诊断能力。方法 回顾性分析4例经手术证实的脾脏硬化性血管瘤样结节性转化的超声影像资料及病理资料。 结果 超声表现：4例均为单发,肿块边界与脾脏组织分界不清,肿块内部回声不均匀;整体表现为低回声3例,等回声1例;4例肿块内部均呈分叶样改变,其中1例肿块内可见散在钙化灶;彩色多普勒表现：肿块内可见血流信号,周边可见多条血管由肿块表面直插进入肿块中心,呈“轮辐状”。 结论 脾脏硬化性血管瘤样结节性转化是一种脾脏的良性病变,临床表现无特异性,术前主要靠影像学检查发现,超声检查有一定的特异性表现,手术切除脾脏后可治愈。     

脾脏硬化性血管瘤样结节性转化的临床病理研究

目的探讨脾脏硬化性血管瘤样结节性转化(SANT)的临床病理特征、诊断及鉴别诊断。方法观察、分析中山大学附属第五医院3例SANT患者的临床影像学资料、病理学特征并复习相关文献。结果低倍镜下显示,脾脏组织中多见结节样结构,类似于肉芽肿的表现,部分结节分界不清。结节内可见窦样、裂隙状或不规则形血管腔结构,以及较肥胖的内皮细胞,结节之间可见增生的纤维组织,部分伴胶原化,伴散在的淋巴细胞、浆细胞浸润,并可见含铁血黄素沉积。免疫组织化学染色显示3种不同类型的血管:CD34~+/CD31~+/CD8~-的毛细血管、CD34~-/CD31~+/CD8~-的小静脉和CD34~-/CD31~+/CD8~+的窦隙。结节间梭形细胞SMA、CD68标记阳性,S-100标记阴性。结论 SANT是一种罕见的脾脏原发的良性瘤样病变,有特征性的组织学及免疫组织化学表现,需要与脾脏的其他良恶性肿瘤及瘤样病变相鉴别。     

脾硬化性血管瘤样结节性转化一例

正患者女,51岁。因"发现脾脏占位1个月余"入院。查体:全身浅表淋巴结未触及肿大,心肺未见阳性体征,腹平软,无异常发现。实验室检查未见明显异常。CT平扫示脾脏内见一类圆形稍低密度灶,CT值约47 HU,边界欠清(图1);MRI示脾脏内见一类圆形占位,其大小约6.3 cm×5.6 cm×6.3 cm,T1WI呈稍低信     

脾脏硬化性血管瘤样结节性转化的诊治进展

脾脏硬化性血管瘤样结节性转化（sclerosing angiomatoid nodular transformation,SANT）是一种较罕见的脾脏良性病变,迄今文献报道不足100例,因以往文献上多为个例报道,加之本病临床表现及影像学改变缺乏特异性,术前常被诊断为脾脏其他病变。近年来,有关SANT的病例报道逐渐增多,为提高临床及病理医师对本病的认识,现就其命名及发病机制、临床病理特点及鉴别诊断要点等方面作一综述。     

脾硬化性血管瘤样结节性转化临床病理观察

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、CDl和ENA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.过去常被归人脾炎性假瘤、错构瘤或血管瘤等.     

脾硬化性血管瘤样结节性转化1例报道并文献复习

目的 报道1例脾硬化性血管瘤样结节性转化(SANT),并回顾相关的文献,探讨其影像学特征,旨在提高术前诊断率,为临床治疗方案的选择提供参考依据.方法 收集该患者的临床及影像资料,回顾相关文献,并分析其影像学特征.结果 脾SANT CT平扫多为等密度结节,增强扫描其强化模式呈渐进性、向心性强化.MRI上T1WI呈等或...     

脾硬化性血管瘤样结节性转化超声表现2例

例1,男,36岁。体检发现脾占位1个月入院。查体:肝脾及浅表淋巴结不大。超声检查:脾大小正常,内见42mm×37mm团状低回声,边界尚清,形态尚规则(图1),考虑脾占位,性质待定,淋巴瘤不除外。磁共振考虑脾错构瘤可能大。行脾切除术,术中见肿块包膜完整,切面不均质。病理结果:脾血管瘤样结节性转化图。1例2,女,37岁。中上腹不适,体检发现肝脾占位入院。查体:肝脾及浅表淋巴结不大。超声检查:肝右叶多个稍高回声团,边界清,最大者26mm×27mm,测及动脉血流频谱,RI0.63;脾肋间切面见52mm×36mm团状低回声,周边测及动脉血流频谱,RI0.66。超声造影:脾内…     

脾脏硬化性血管瘤样结节性转化一例并文献复习

目的探讨脾脏硬化性血管瘤样结节性转化(SANT)的诊断、鉴别诊断及治疗,提高对SANT的认识,避免误诊。方法对1例SANT患者的临床、病理特征、免疫组化表达及术后随访情况进行分析并复习文献。结果 SANT是一种近几年报道的罕见疾病,因其临床表现及影像学检查无特异性,非常容易引起误诊,确诊需依赖其特征性的病理学形态及免疫组织化学染色。结论 SANT是一种比较罕见的良性病变,预后良好,行脾切除术可以治愈。     

A case of sclerosing angiomatoid nodular transformation of the spleen: Correlations between contrast‐enhanced ultrasonography and histopathologic findings

Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized benign vascular lesion of the spleen. Detection of SANT as an incidentaloma has increased due to improvements in imaging techniques. However, a definitive diagnosis of SANT on CT or MRI remains difficult. We report the use of contrast‐enhanced ultrasonography with Sonazoid in a case of SANT in a 50‐year‐old woman, with gross and microscopic pathologic correlations. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42 :103–107, 2014     

Hand‐assisted laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen complicated by chronic disseminated intravascular coagulation: A case report

A 36‐year‐old man who presented with a nosebleed and anemia was referred to our hospital. Laboratory test results showed platelet depletion, decreased levels of fibrinogen, and increased fibrinogen degeneration products. CT showed a 13‐cm splenic tumor. T₂‐weighted MRI revealed a high‐intensity mass. We preoperatively diagnosed splenic hemangioma with chronic disseminated intravascular coagulation and scheduled an operation to relieve the disseminated intravascular coagulation. We also performed hand‐assisted laparoscopic splenectomy to ensure easy handling of the splenomegaly. The resected specimen microscopically consisted of hemorrhages and hemangiomatous lesions, and multiple angiomatoid nodules were scattered and separated by fibrocollagenous stroma with inflammatory cells. Three types of vessels (capillaries, sinusoids and small veins) were contained in the angiomatoid nodules, and the pathological diagnosis was sclerosing angiomatoid nodular transformation. The results of this case suggest that we should consider sclerosing angiomatoid nodular transformation in the differential diagnosis of patients with splenic tumors, as sclerosing angiomatoid nodular transformation with hemangiomatous features may cause coagulation disorders for which splenectomy should be performed.     

脾硬化性血管瘤样结节性转化临床病理观察

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、鉴别诊断、治疗及预后。方法分析1例SANT患者的临床病理特征及免疫组化表达,并复习相关文献。结果镜下病变呈多个硬化性血管瘤样结节,结节中央为裂隙样及不规则的富含红细胞的血管样腔隙,边缘间质内见数量不等的淋巴细胞、浆细胞及组织细胞浸润。免疫组化示vimentin弥漫(+),血管瘤样结节CD31和CD34(+),CD8(-);多结节CD235α及CD 61(+);结节中靶环状排列的梭形细胞及卵圆形细胞SMA、actin、CD 68、S-100、lysozyme、EMA及CD1α不同程度(+);CK-pan、ALK、CD21、CD23均(-)。随访6个月无复发及转移。结论SANT是一种罕见具有独特的临床病理改变的良性病变,确诊需依据其特征性的病理学形态及免疫组化结果,脾切除术可以治愈。     

脾硬化性血管瘤样结节样转化1例

患者女,41岁,主因“左上腹阵发性隐痛1个月,加重1天伴绞痛1h”入院.查体未见明显异常,肿瘤标志物、血常规、肝肾功能、电解质均正常.CT:脾实质前部团块状稍低密度灶,边界不清,密度欠均匀,增强呈向心性强化,动脉期病灶边缘环状强化,门静脉期强化范围稍扩大,延迟期强化范围推进至病灶中央,但中央裂隙样低密度灶始终未见强化.     

Sclerosing angiomatoid nodular transformation of the spleen: A case report and literature review

BACKGROUNDSclerosing angiomatoid nodular transformation (SANT) is a rare disease of the spleen. It has unique pathological features and mimics splenic tumor on radiological imaging.CASE SUMMARYA 47-year-old woman was incidentally found to have a splenic mass on abdominal ultrasound. She had a 10-cm postoperative scar in the lower abdomen due to previous cesarean sections. The patient had a past history of anemia of unknown etiology for 20 years. The patient underwent laparoscopic splenectomy. The postoperative course was uneventful, with a hospital stay of 7 d. The histopathological examination of the spleen revealed SANT. At the 6-mo follow-up, the patient remained disease-free.CONCLUSIONSANT is a rare benign disease mimicking a malignant tumor. A definitive diagnosis can be made only on histopathology.     

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: Sonographic finding

Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized benign vascular lesion of the spleen. There is limited information regarding its imaging findings of this condition. Until now, the diagnosis was based on histopathologic examination of splenectomy specimens. We report the sonographic findings in a case of SANT of the spleen confirmed by ultrasound‐guided core needle biopsy. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009     

Sclerosing angiomatoid nodular transformation of the spleen,a rare cause for splenectomy: Two case reports

BACKGROUND Sclerosing angiomatoid nodular transformation(SANT)is a rare benign disease of the spleen with unknown origin.Clinical symptoms are inhomogeneous,and suspicious splenic lesion often found incidentally,leading to splenectomy,as malignancy cannot securely be ruled out.Diagnosis is made histologically after resection.CASE SUMMARY Two cases of German,white,non-smoking,and non-drinking patients of normal weight are presented.The first one is a 26-year-old man without medical history who was exhibiting an undesired weight loss of 10 kg and recurring vomiting for about 18 mo.The second one is a 65-year-old woman with hypertension who had previously undergone gynecological surgery,suffering from a lasting feeling of abdominal fullness.Both showed radiologically an inhomogeneous splenic lesion leading to splenectomy approximately 6 and 9 wk after surgical presentation.Both diagnoses of SANT were made histologically.Follow-up went well,and both were treated according to the recommendation for asplenic patients.CONCLUSION SANT is a rare cause of splenectomy and an incidental histological finding.Further research should focus on clinical and radiological diagnosis of SANT as well as on treatment of patients with asymptomatic and small findings.