Alemu Seifu, Mulatu Bilisuma, Kedir Abdo, Minka Milkias, Tesfaye Workneh, Reta Demissie Wondu
Jimma University, Institute of Health, Faculty of Medical Sciences, Department of Surgery, Jimma, Ethiopia.
Jimma University, Institute of Health, Faculty of Medical Sciences, Department of Pathology, Jimma, Ethiopia.
Int J Surg Case Rep. 2025 Jan;126:110745. doi: 10.1016/j.ijscr.2024.110745. Epub 2024 Dec 15.
Sclerosing angiomatoid nodular transformation of the spleen is a rare benign vascular lesion arising from red pulp of spleen with unknown etiopathogenesis. It is a non-neoplastic condition that affects the spleen only; not described in other sites except one case reported in adrenal gland. Epidemiologically it has slight female predilection. It is a very rare ailment where the present finding is very crucial in the management of similar cases so far.
A 31 years old female patient presented with left flank pain and constipation of 01 year duration. An abdominopelvic CT scan showed a hypodense mass in the left upper quadrant of abdomen just anterior to inferior pole of spleen with the conclusion of mesenteric mass likely gastrointestinal stromal tumor. Finally, it was decided and exploratory laparotomy was done and the surgeon identified the mass in the inferior pole of spleen and total splenectomy was done, and the specimen is sent for pathologic evaluation. The final histopathologic diagnosis became sclerosing angiomatoid nodular transformation of spleen with the classic microscopic findings of multiple confluent angiomatoid nodules surrounded by variable concentric fibrosclerotic stroma.
Sclerosing angiomatoid nodular transformation of spleen is a benign incidentally identified vascular condition of red pulp in the majority of cases. Preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, splenectomy has become the more standard procedure for the spleen for both diagnosis and treatment with no recurrence reported after splenectomy.
脾脏硬化性血管瘤样结节性转化是一种罕见的良性血管病变，起源于脾脏红髓，病因不明。它是一种仅累及脾脏的非肿瘤性疾病；除肾上腺有一例报道外，其他部位未见描述。流行病学上，女性略占优势。这是一种非常罕见的疾病，目前的发现对于迄今为止类似病例的处理至关重要。
一名31岁女性患者，出现左侧胁腹疼痛和便秘，病程1年。腹部盆腔CT扫描显示，在脾脏下极前方的左上腹有一个低密度肿块，结论为肠系膜肿块，可能是胃肠道间质瘤。最后决定进行剖腹探查，外科医生在脾脏下极发现了肿块，进行了全脾切除术，并将标本送去做病理评估。最终病理组织学诊断为脾脏硬化性血管瘤样结节性转化，具有多个融合的血管瘤样结节被不同程度的同心纤维硬化性间质包绕的典型显微镜下表现。
脾脏硬化性血管瘤样结节性转化在大多数情况下是一种偶然发现的脾脏红髓良性血管病变。术前诊断并不容易，因为很难从脾脏获取组织进行病理研究。最近，脾切除术已成为诊断和治疗脾脏更标准的手术，脾切除术后未见复发报道。
