Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
Clin J Gastroenterol. 2024 Feb;17(1):198-203. doi: 10.1007/s12328-023-01869-9. Epub 2023 Oct 13.
A 48-year-old woman underwent transcatheter arterial embolization (TAE) for a splenic artery aneurysm, which resulted in a partial splenic infarction in the middle lobe. Five years after TAE, a 20-mm diameter mass in the noninfarcted area of the spleen was detected on imaging, which grew to 25 mm in diameter after 6 months. MRI after gadolinium administration showed a 35 × 34 mm mass within the superior pole and 15 × 12 mm mass within the inferior pole. The patient underwent laparoscopic splenectomy and had an uneventful postoperative recovery. No evidence of recurrence was observed during the 2-year follow-up period after surgery. The mass was pathologically confirmed to be sclerosing angiomatoid nodular transformation (SANT) of the spleen. While some studies hypothesize that SANT is a response to vascular injury or trauma, to the best of our knowledge, there have been no previous reports of SANT occurring after procedures directly affecting splenic blood flow. Additionally, multifocal SANTs are reported to be very rare, accounting for only 4.7% of all reported SANTs of the spleen. We highlight a rare course of SANT of the spleen and discuss the possible relationship between blood flow abnormalities and the appearance of SANT.
一位 48 岁女性因脾动脉瘤接受了经导管动脉栓塞术（TAE）治疗，导致中叶部分脾梗死。TAE 后 5 年，在非梗死区脾脏发现一个 20 毫米直径的肿块，6 个月后直径增长至 25 毫米。钆增强 MRI 显示脾脏上极有一个 35×34 毫米的肿块和下极有一个 15×12 毫米的肿块。患者接受了腹腔镜脾切除术，术后恢复顺利。术后 2 年随访期间未观察到复发迹象。肿块的病理证实为脾脏硬化性血管样结节性转化（SANT）。虽然一些研究假设 SANT 是对血管损伤或创伤的反应，但据我们所知，以前没有报道过 TAE 等直接影响脾血流的手术之后会发生 SANT。此外，多灶性 SANT 非常罕见，仅占所有报道的脾脏 SANT 的 4.7%。我们强调了一种罕见的脾脏 SANT 病程，并讨论了血流异常与 SANT 出现之间的可能关系。
