Usuda H, Naito M
Second Department of Pathology, Niigata University School of Medicine, Japan.
Pathol Int. 1997 Aug;47(8):553-6. doi: 10.1111/j.1440-1827.1997.tb04539.x.
A case of multicentric gastrointestinal angiosarcoma suffering from severe melena is presented. Endoscopical examination revealed two polyps in the stomach and duodenum. Histological examination showed angiosarcoma. Although a gastroduodenectomy was performed, severe melena continued, and the patient developed respiratory failure and died. At autopsy, multiple hemorrhagic tumors were present from the duodenum to the cecum. Histologically the tumors demonstrated vasoformative structure and were immunohistochemically positive for von Willebrand factor (factor VIII related antigen), CD34, and CD31. Numerous metastases were found in various organs, including the lungs, bones, liver, gall-bladder, and lymph nodes. The patient had received hemodialysis for 21 years due to chronic renal failure. Long-term dialysis had been associated with various malignancies. Multicentric development of angiosarcoma in the present case may also be related to long-term dialysis.
本文报告一例患有严重黑便的多中心胃肠道血管肉瘤病例。内镜检查发现胃和十二指肠有两个息肉。组织学检查显示为血管肉瘤。尽管进行了胃十二指肠切除术，但严重黑便仍持续存在，患者出现呼吸衰竭并死亡。尸检时，从十二指肠到盲肠发现多个出血性肿瘤。组织学上，肿瘤呈现血管形成结构，免疫组化显示血管性血友病因子（因子VIII相关抗原）、CD34和CD31呈阳性。在包括肺、骨、肝、胆囊和淋巴结在内的各个器官中发现了大量转移灶。该患者因慢性肾衰竭接受血液透析21年。长期透析与各种恶性肿瘤有关。本例血管肉瘤的多中心发生也可能与长期透析有关。
