Chan J K, Warnke R A, Dorfman R
Department of Pathology, Stanford University School of Medicine, California.
Am J Surg Pathol. 1991 Aug;15(8):732-43. doi: 10.1097/00000478-199108000-00003.
Vascular transformation of lymph node sinuses (VTS) is characterized by conversion of nodal sinuses into capillary-like channels, often accompanied by fibrosis. A detailed study of this entity, based on 76 cases, showed that the morphologic spectrum was much broader than that originally described. The vasoproliferative process caused variable expansion of the subcapsular, intermediate, and medullary sinuses of the lymph nodes and involved single or multiple lymph nodes in a diffuse or segmental fashion. The proliferated vessels formed anastomosing narrow clefts, rounded spaces of different sizes, plexiform channels, or solid spindled to plump cellular foci and often were associated with variable degrees of sclerosis. The vascular spaces were empty, filled with lymph-like fluid, congested with blood, or occasionally thrombosed; extravasation of red cells was common. Several patterns were commonly observed in an individual case. Less common features included perivascular fibrin deposition and the presence of eosinophilic globules. Vascular thrombosis was identified only rarely in extranodal vessels available for histologic assessment. The more cellular forms of this vascular transformation may be mistaken for Kaposi's sarcoma, but can be distinguished from it by the pure sinusoidal distribution, a lack of well-formed spindle cell fascicles, the associated fibrosis, the maturation of the spindle cells into well-formed vascular channels toward the capsular aspect, and the failure of this process to involve the capsule itself, which is frequently affected by Kaposi's sarcoma.
淋巴结窦血管转化（VTS）的特征是淋巴结窦转化为毛细血管样通道，常伴有纤维化。一项基于76例病例的对该实体的详细研究表明，其形态学谱比最初描述的要广泛得多。血管增生过程导致淋巴结被膜下、中间和髓窦不同程度的扩张，以弥漫或节段方式累及单个或多个淋巴结。增生的血管形成吻合的狭窄裂隙、大小不一的圆形间隙、丛状通道或实性的梭形至饱满的细胞灶，且常伴有不同程度的硬化。血管腔可为空的、充满淋巴样液体、充血或偶尔血栓形成；红细胞外渗很常见。在单个病例中通常可观察到几种模式。较少见的特征包括血管周围纤维蛋白沉积和嗜酸性小球的存在。在可用于组织学评估的结外血管中仅很少发现血管血栓形成。这种血管转化的细胞丰富形式可能被误诊为卡波西肉瘤，但可通过其单纯的窦状分布、缺乏成熟的梭形细胞束、相关的纤维化、梭形细胞向被膜侧成熟为成熟的血管通道以及该过程不累及常受卡波西肉瘤影响的被膜本身而与之区分。
