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脾脏硬化性血管瘤样结节性转化:5例临床及病理特征分析

Sclerosing Angiomatoid Nodular Transformation of the Spleen: Analysis of Clinical and Pathological Features in Five Cases.

作者信息

Shao Huijiang, Lu Baochun, Shen Zhihong, Liu Fang

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Department of Pathology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China.

出版信息

Front Surg. 2021 Feb 1;7:609284. doi: 10.3389/fsurg.2020.609284. eCollection 2020.

Abstract

We aimed to summarize the clinical and pathological features of sclerosing angiomatoid nodular transformation (SANT) in spleen among five cases. Five cases (male: 3; female: 2; mean age: 47.6 years) with SANT confirmed by pathological analysis between July 2010 and November 2019 in our hospital were included in this study. The clinical, imaging, and pathological data were analyzed retrospectively. Three patients presented with mild abdominal pain or discomfort, while the other two were symptom free. Two patients received ultrasonography (US), and all patients underwent a computerized tomography (CT) scan in our hospital. The typical "spoke wheel" pattern was seen in two cases, and central calcification was detected in one case on the CT scans. All patients indicated peripheral enhancement around the SANT lesion during the arterial phase. Open or laparoscopic splenectomy was performed for treatment. No patient showed recurrence in the follow-up. The pathological characteristics of our cases were in line with those of previous literatures. Peripheral enhancement around the SANT lesion during the arterial phase should be taken into consideration for the diagnosis of SANT as an imaging sign on CT scans. Special attention should be paid to the splenic integrality during the laparoscopic approach, due to the probability of malignancy and the fragility of the spleen.

摘要

我们旨在总结5例脾脏硬化性血管瘤样结节性转化(SANT)的临床和病理特征。本研究纳入了2010年7月至2019年11月期间在我院经病理分析确诊为SANT的5例患者(男性3例;女性2例;平均年龄47.6岁)。对临床、影像和病理数据进行回顾性分析。3例患者表现为轻度腹痛或不适,另外2例无症状。2例患者接受了超声检查(US),所有患者均在我院接受了计算机断层扫描(CT)。CT扫描中2例可见典型的“辐条轮”样表现,1例检测到中央钙化。所有患者在动脉期均显示SANT病变周围有外周强化。采用开放或腹腔镜脾切除术进行治疗。随访期间无患者复发。我们病例的病理特征与既往文献一致。动脉期SANT病变周围的外周强化应作为CT扫描上SANT诊断的影像学征象予以考虑。由于存在恶性可能性以及脾脏的脆弱性,在腹腔镜手术过程中应特别注意脾脏的完整性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b19/7901957/011a4c515393/fsurg-07-609284-g0001.jpg

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