Wadhwa Sanya, Kim Tae Hun, Lin Leah, Kanel Gary, Saito Takeshi
Sanya Wadhwa, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States.
World J Gastroenterol. 2017 Apr 7;23(13):2443-2447. doi: 10.3748/wjg.v23.i13.2443.
Hepatic angiosarcoma is a mesenchymal tumor originating from liver sinusoidal endothelial cells. It is an extremely rare malignant neoplasm accounting for less than 1% of primary malignant liver tumors. The deregulated coagulopathy that can be seen in hepatic angiosarcoma fulfills the clinical diagnostic criteria of disseminated intravascular coagulation. However, the mechanism that governs this coagulopathy has been poorly understood. This case report provides histological evidence of the consumption of coagulation factors along with trapped platelets occurring within the tumor, which is the foundation for the concept of Kasabach-Merritt syndrome (KMS). KMS is characterized by thrombocytopenia and hyperconsumption of coagulation factors within a vascular tumor. However, KMS associated with angiosarcoma has not been well recognized. This case report describes, for the first time, the histological evidence of KMS that occurred in an extremely rare mesenchymal malignant tumor of the liver.
肝血管肉瘤是一种起源于肝窦内皮细胞的间质性肿瘤。它是一种极其罕见的恶性肿瘤,占原发性恶性肝肿瘤的比例不到1%。肝血管肉瘤中可见的凝血功能障碍符合弥散性血管内凝血的临床诊断标准。然而,这种凝血功能障碍的机制尚未得到充分了解。本病例报告提供了肿瘤内凝血因子消耗以及血小板滞留的组织学证据,这是卡萨巴赫-梅里特综合征(KMS)概念的基础。KMS的特征是血管肿瘤内血小板减少和凝血因子过度消耗。然而,与血管肉瘤相关的KMS尚未得到充分认识。本病例报告首次描述了在一种极其罕见的肝脏间质性恶性肿瘤中发生KMS的组织学证据。