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脾脏硬化性血管瘤样结节性转化,脾切除术的罕见病因:两例病例报告。

Sclerosing angiomatoid nodular transformation of the spleen, a rare cause for splenectomy: Two case reports.

作者信息

Chikhladze Sophia, Lederer Ann-Kathrin, Fichtner-Feigl Stefan, Wittel Uwe A, Werner Martin, Aumann Konrad

机构信息

Department of General and Visceral Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.

Institute of Surgical Pathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.

出版信息

World J Clin Cases. 2020 Jan 6;8(1):103-109. doi: 10.12998/wjcc.v8.i1.103.

Abstract

BACKGROUND

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign disease of the spleen with unknown origin. Clinical symptoms are inhomogeneous, and suspicious splenic lesion often found incidentally, leading to splenectomy, as malignancy cannot securely be ruled out. Diagnosis is made histologically after resection.

CASE SUMMARY

Two cases of German, white, non-smoking, and non-drinking patients of normal weight are presented. The first one is a 26-year-old man without medical history who was exhibiting an undesired weight loss of 10 kg and recurring vomiting for about 18 mo. The second one is a 65-year-old woman with hypertension who had previously undergone gynecological surgery, suffering from a lasting feeling of abdominal fullness. Both showed radiologically an inhomogeneous splenic lesion leading to splenectomy approximately 6 and 9 wk after surgical presentation. Both diagnoses of SANT were made histologically. Follow-up went well, and both were treated according to the recommendation for asplenic patients.

CONCLUSION

SANT is a rare cause of splenectomy and an incidental histological finding. Further research should focus on clinical and radiological diagnosis of SANT as well as on treatment of patients with asymptomatic and small findings.

摘要

背景

硬化性血管瘤样结节性转化(SANT)是一种起源不明的脾脏罕见良性疾病。临床症状不具有特异性,可疑的脾脏病变常为偶然发现,由于无法完全排除恶性肿瘤,常导致脾脏切除。切除术后通过组织学检查进行诊断。

病例总结

介绍了两例德国白人患者,均不吸烟、不饮酒,体重正常。第一例是一名26岁无病史男性,出现了10kg的意外体重减轻和持续约18个月的反复呕吐。第二例是一名65岁患有高血压的女性,曾接受过妇科手术,有持续的腹部饱胀感。两人影像学检查均显示脾脏病变不均匀,分别在手术就诊后约6周和9周进行了脾脏切除。两例均通过组织学检查诊断为SANT。随访情况良好,两人均按照无脾患者的建议进行治疗。

结论

SANT是脾脏切除的罕见原因,也是偶然的组织学发现。进一步的研究应集中在SANT的临床和影像学诊断以及无症状和小病灶患者的治疗上。

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