Compérat Eva, Bardier-Dupas Armelle, Camparo Philippe, Capron Frédérique, Charlotte Frédéric
Service d'Anatomie Pathologique, Hôpital Pitié-Salpêtrière, Boulevard de l'hôpital, 75013 Paris, France.
Arch Pathol Lab Med. 2007 Jun;131(6):965-9. doi: 10.5858/2007-131-965-SMCPDD.
Splenic metastases from solid tumors, defined as parenchymal lesion, are considered exceptional. Nevertheless, the number of case reports has been increasing due to the improvement of imaging techniques and the long-term follow-up of patients with cancer. Splenic metastases occur in a context of multivisceral disseminated cancer or as a solitary lesion.
To provide a general overview of the clinicopathologic features, differential diagnosis, and pathogenesis of splenic metastases.
Relevant articles indexed in PubMed (National Library of Medicine) database. The search was based on the following terms: (metastasis or metastases) and spleen.
The most common primary sources of splenic metastasis are breast, lung, colorectal, and ovarian carcinomas and melanoma in cases of multivisceral cancer and colorectal and ovarian carcinomas in cases of solitary splenic lesion. Splenectomy can be replaced by less aggressive methods such as fine-needle aspiration or percutaneous biopsy for establishing the diagnosis of solitary splenic metastasis. The main differential diagnoses are primary lymphoma, vascular tumors, and infectious lesions of the spleen. The relative rarity of splenic metastases could be explained by anatomic factors and the inhibitory effect of the splenic microenvironment on the growth of metastatic cells. The analysis of clinical case reports suggests that solitary splenic metastases may result from the growth of an early blood-borne micrometastasis following a period of clinical latency, often several years after the diagnosis of the primary tumor.
实体瘤的脾转移定义为实质病变，被认为较为罕见。然而，由于成像技术的改进以及癌症患者的长期随访，病例报告数量一直在增加。脾转移发生在多脏器播散性癌症的背景下或作为孤立性病变出现。
对脾转移的临床病理特征、鉴别诊断及发病机制进行概述。
美国国立医学图书馆的PubMed数据库中索引的相关文章。搜索基于以下术语：（转移或转移灶）和脾脏。
脾转移最常见的原发部位在多脏器癌症病例中是乳腺癌、肺癌、结直肠癌、卵巢癌和黑色素瘤，在孤立性脾病变病例中是结直肠癌和卵巢癌。对于孤立性脾转移的诊断，脾切除术可被侵袭性较小的方法如细针穿刺或经皮活检所取代。主要的鉴别诊断包括原发性淋巴瘤、血管肿瘤和脾脏感染性病变。脾转移相对罕见的原因可能是解剖学因素以及脾微环境对转移细胞生长的抑制作用。对临床病例报告的分析表明，孤立性脾转移可能是由于早期血行微转移在一段临床潜伏期后生长所致，通常是在原发性肿瘤诊断后的数年。
