Hou Jun, Ji Yuan, Tan Yun-shan, Shi Da-ren, Liu Ya-lan, Xu Chen, Zeng Hai-ying
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
Zhonghua Bing Li Xue Za Zhi. 2010 Feb;39(2):84-7.
To study the clinicopathologic features, differential diagnosis and pathogenesis of sclerosing angiomatoid nodular transformation of spleen.
Ten cases of sclerosing angiomatoid nodular transformation of spleen were retrieved from the archival file. Histochemical and immunohistochemical (EnVision method) studies were performed. Ultrastructural findings were also available in one of them.
Sclerosing angiomatoid nodular transformation was characterized by micronodular appearance of vascular spaces lined by plump endothelial cells with interspersed ovoid spindle cells. Immunohistochemical study showed that the endothelial cells of vessels in the angiomatoid nodules had various expressions of immunologic phenotypes and could be mainly classified into 3 types: CD34(+)/CD31(+)/CD8⁻ endothelial cells of the capillaries, CD8(+)/CD31(+)/CD34⁻ lining cells of the sinusoids and CD31(+)/CD8⁻/CD34⁻ endothelial cells of the small veins. Collagen network and dilated lymphatic sinuses were evident under transmission electron microscope.
Sclerosing angiomatoid nodular transformation of spleen is a rare benign entity. It may represent a reactive condition and bears some relationship with splenic angioma. It needs to be distinguished from borderline or malignant vascular tumors of spleen.
研究脾脏硬化性血管瘤样结节性转化的临床病理特征、鉴别诊断及发病机制。
从存档文件中检索出10例脾脏硬化性血管瘤样结节性转化病例。进行了组织化学和免疫组织化学(EnVision法)研究。其中1例还提供了超微结构检查结果。
脾脏硬化性血管瘤样结节性转化的特征为血管间隙呈微结节状,内衬丰满的内皮细胞,其间散在卵圆形梭形细胞。免疫组织化学研究显示,血管瘤样结节内血管的内皮细胞具有多种免疫表型表达,主要可分为3种类型:毛细血管的CD34(+)/CD31(+)/CD8⁻内皮细胞、血窦的CD8(+)/CD31(+)/CD34⁻衬里细胞和小静脉的CD31(+)/CD8⁻/CD34⁻内皮细胞。透射电镜下可见胶原网络和扩张的淋巴窦。
脾脏硬化性血管瘤样结节性转化是一种罕见的良性病变。它可能代表一种反应性病变,与脾血管瘤有一定关系。它需要与脾脏的交界性或恶性血管肿瘤相鉴别。