脾脏窦岸细胞血管瘤的临床、病理及影像学表现

目的 总结脾脏窦岸细胞血管瘤的临床、病理及影像学表现,以提高对该病的认识.资料与方法 我院2007-07～2011-08收治经手术病理确诊的5例脾脏窦岸细胞血管瘤,总结其临床、病理和影像学表现.结果 5例患者中,2例合并恶性肿瘤;2例为多发,3例为单发.多发肿块直径0.5～3cm,单发肿块直径5.5～9.5cm.超声声像图上可表现为低、等、强回声,血流超声可有或无血流信号.CT平扫表现为等或低密度肿块,增强扫描多呈不均匀渐进式强化.1例患者11C-乙酸盐及18F-脱氧葡萄糖(FDG) PET/CT检查未见阳性发现.5例患者均行脾脏切除术.病理组织学上肿瘤由大小不等、互相吻合的血管性腔隙组成,腔隙被覆低柱状或立方形内皮细胞,无明显异型性.肿瘤细胞免疫表型CD31和CD68均阳性.结论 脾脏窦岸细胞血管瘤是一种脾脏特有的、罕见的良性血管性肿瘤,临床常无特异表现,增强CT表现可提示其血管性肿瘤特征,确诊依赖病理形态学和免疫组织化学检查.

Littoral Cell Angioma of the Spleen: Clinical, Pathological Findings and Imaging Features

Purpose To summarize the clinical manifestations, pathological diagnosis and imaging findings of littoral cell angioma (LCA) of spleen so as to improve awareness of the disease. Materials and Methods From July 2007 to August 2011, there were five patients with pathologically proven LCA in our hospital. The clinical, pathological and imaging information of all 5 patients were collected and summarized. Results Two of five cases had concomitant malignancies. LCA appeared to be multiple masses in two cases and solitary in the other three cases. The diameter of the multiple masses was 0.5-3 cm, while that of the solitary mass was 5.5-9.5 cm. The mass was hypo-, iso- or hyper-echogenic in ultrasound with or without blood flow signal. The mass was iso- or hypo-dense in plain CT and had inhomogeneous progressive enhancement after contrast enhancement. One case underwent 11C-acetate and 18F-glucose PET/CT imaging, and no positive finding was revealed. All five patients underwent splenectomy. Histopathologically, the tumor was comprised of anastomosing vascular lumens which was lined by cuboid or low column epithelium. Immunohistologically, both CD31 and CD68 were positive. Conclusion LCA is a rare, benign vascular tumor unique to the spleen. There is no specific clinical presentation. The contrast enhanced CT may indicate its vascular origin. The final diagnosis relies on histological and immunohistological exams.