Hasegawa Takashi, Arakawa Yoshiki, Minamiguchi Sachiko, Mineharu Yohei, Nakajima Satoshi, Nakajima Kohei, Hirose Takanori, Haga Hironori, Miyamoto Susumu
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan.
Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan.
NMC Case Rep J. 2022 Jun 21;9:187-192. doi: 10.2176/jns-nmc.2022-0079. eCollection 2022.
Tufted angioma is a benign vascular tumor in which immature endothelial and pericyte cells and lymphatic vascular endothelium grow. It manifests as a flat, painful erythema that gradually expands mainly on the trunk and extremities. Although tufted angiomas can also occur in other areas of the body and may be more locally invasive, they rarely occur intracranially. A 63-year-old man underwent magnetic resonance imaging (MRI) for a brain check-up 8 years before his visit to our institute, which detected a mass lesion with surrounding cerebral edema in the left frontal lobe. The patient was followed up with annual MRI analysis, which indicated slow tumor growth and gradual development of peritumoral edema. The tumor was treated by gross-total resection. Histological analysis showed a slightly dilated microvascular core surrounded by many capillary aggregates in the brain parenchyma. Immunohistochemical findings indicated that the vascular endothelial cells were positive for CD34 and Brahma-related gene-1 and were surrounded by smooth muscle actin-positive pericytes. These findings were consistent with tufted angioma. Intracranial tufted angioma is uncommon, but it should be considered in the differential diagnosis for intracranial tumorous lesions. Long-term follow-up is necessary to unravel the natural history of the disease.
丛状血管瘤是一种良性血管肿瘤，其中未成熟的内皮细胞、周细胞和淋巴管内皮细胞生长。它表现为扁平、疼痛性红斑，主要在躯干和四肢逐渐扩大。虽然丛状血管瘤也可发生于身体其他部位，且可能具有更强的局部侵袭性，但很少发生于颅内。一名63岁男性在来我院就诊前8年因脑部检查接受了磁共振成像（MRI），检查发现左额叶有一肿块伴周围脑水肿。患者每年接受MRI分析随访，结果显示肿瘤生长缓慢且瘤周水肿逐渐加重。该肿瘤通过全切除进行治疗。组织学分析显示脑实质内有一个轻度扩张的微血管核心，周围有许多毛细血管聚集。免疫组化结果表明，血管内皮细胞CD34和Brahma相关基因-1呈阳性，周围有平滑肌肌动蛋白阳性的周细胞。这些发现与丛状血管瘤一致。颅内丛状血管瘤并不常见，但在颅内肿瘤性病变的鉴别诊断中应予以考虑。有必要进行长期随访以了解该疾病的自然病程。
