Department of Pathology, ESIC Medical College, Faridabad, Haryana, India.
Indian J Pathol Microbiol. 2024 Jul 1;67(3):691-694. doi: 10.4103/ijpm.ijpm_452_22. Epub 2023 Jul 10.
Sclerosing angiomatoid nodular transformation (SANT) is a reactive non-neoplastic, rare vascular lesion of the spleen. The histology shows multiple angiomatoid nodules surrounded by proliferative stroma. A 31-year-old lady presented with an abdominal mass for 6 months. Contrast-enhanced computed tomography (CECT) abdomen was suggestive of hemangiopericytoma/hemangioendothelioma. An open splenectomy was performed, and the resected specimen was sent for histopathology examination. The gross examination showed a bosselated mass present at the lower pole of the spleen measuring 8 × 8 cm with peripherally located coalescing red-brown nodules embedded in a dense fibrous stroma on the cut surface. On microscopy, multiple circumscribed angiomatoid nodules comprising irregular slit-like vascular channels lined by plump endothelial cells were seen embedded in dense sclerotic stroma. Because of the lack of specific diagnostic features, it is difficult to diagnose SANT clinically and radiologically. However, the typical histopathological findings are a clue in clinching the diagnosis.
硬化性血管样结节性转化(SANT)是一种脾脏的反应性非肿瘤性、罕见的血管病变。组织学表现为多个血管瘤样结节,周围有增生的基质。一名 31 岁女性因腹部肿块就诊 6 个月。腹部增强 CT(CECT)提示为血管外皮细胞瘤/血管内皮细胞瘤。行开放性脾切除术,切除标本送组织病理学检查。大体检查显示脾脏下极有一结节状肿块,大小为 8×8cm,表面有多个融合的棕红色结节,切面可见位于致密纤维基质中的融合棕红色结节。镜下,多个界限清楚的血管瘤样结节,由富含内皮细胞的不规则裂隙状血管组成,嵌入致密的硬化性基质中。由于缺乏特异性诊断特征,SANT 在临床和影像学上的诊断较为困难。然而,典型的组织病理学表现是确诊的线索。