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一例不典型性血管肌脂瘤样结节性转化:影像学和组织病理学分析。

An unusual case of sclerosing angiomatoid nodular transformation: radiological and histopathological analyses.

机构信息

Department of Radiology, Atatürk Education and Research Hospital, Ankara, Turkey.

出版信息

Turk J Med Sci. 2014;44(3):530-3.

Abstract

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign primary vascular lesion of the spleen. Its etiology is still debated. Radiological characteristics are less known, although there are some reports regarding histopathological features ofSANT. A 21-year-old male patient was admitted to our hospital with fatigue, weight loss, and abdominal pain for 4 months. Physical examination, complete blood count, andbiochemical parameters were unremarkable. Dynamic contrast-enhanced computed tomography (CT) of the abdomen was performed. A heterogeneous well-defined hyperdense nodular lesion 3 cm in diameter was detected during the arterial phase. The detected lesion was seen as isodense with the spleen parenchyma during the portal venous and late venous phases. Magnetic resonance imaging (MRI) showed an isointense-hypointense nodular lesion on T1- and T2-weighted images. Intraabdominal LAM or splenomegaly was not detected. Microscopically, it was composed of angiomatoid nodules separated by central stellate fibrous stroma and fibrous septa. The contrast enhancement pattern was described as centrally hypovascular, radially progressive centripetal vascular contrast enhancement, called a spoke-wheel pattern in previously reported cases. We present CT and MRI findings and their correlation with histopathological findings of a case of unusual symptomatic SANT.

摘要

硬化性血管样结节性转化(SANT)是一种罕见的脾脏原发性良性血管病变。其病因仍存在争议。尽管有一些关于 SANT 组织病理学特征的报道,但放射学特征知之甚少。一名 21 岁男性患者因疲劳、体重减轻和腹痛 4 个月入院。体格检查、全血细胞计数和生化参数均无异常。行腹部动态对比增强 CT 检查。动脉期检测到直径 3cm 的不均匀边界清晰的高密度结节状病变。门静脉期和晚期静脉期,检测到的病变与脾脏实质等密度。磁共振成像(MRI)显示 T1 和 T2 加权图像上呈等信号-低信号结节状病变。未检测到腹腔内淋巴管平滑肌瘤病或脾肿大。镜下由血管样结节组成,中央星状纤维基质和纤维隔分开。增强模式描述为中央低血供,放射状进行性向心性血管增强,在以前报道的病例中称为辐轮样模式。我们提出了一例罕见症状性 SANT 的 CT 和 MRI 表现及其与组织病理学表现的相关性。

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