脾脏窦岸细胞血管瘤影像表现及临床分析

Imaging Findings and Clinical Analysis of Littoral Cell Angioma

目的探讨脾脏窦岸细胞血管瘤的影像表现及临床特征。方法回顾性分析经病理证实的8例脾脏窦岸细胞血管瘤患者的影像及临床特征。结果 8例患者中,3例脾大,5例为多发病灶,3例为单发;病灶大小从点状到直径68 mm不等,为类圆形结节;5例边界清楚,3例边界模糊,均无包膜及钙化;7例CT检查,平扫均为低密度结节,增强扫描3例为静脉期渐进性强化,4例为动脉期明显强化,静脉期减低;1例MRI平扫表现为稍长T2信号,增强为延迟强化;2例PET/CT,1例放射性分布稀疏,1例放射性分布未见异常;6例超声检查,1例为实质回声欠均匀,2例为实性稍低回声,内回声欠均匀,CDFI内可及较丰富血流信号;3例为实性稍高回声结节,内回声欠均匀,CDFI内未见明显血流信号。结论脾脏窦岸细胞血管瘤是罕见的良性肿瘤,常为多发病灶,临床表现不典型,部分有脾大、脾亢。影像学表现为类血管瘤样特点,能明确肿瘤血供情况,确诊依靠病理及免疫组织化学检查。

Objective To investigate the imaging findings and clinical features of littoral cell angioma. Methods The CT and clinical features of 8 patients of littoral cell angioma treated in our hospital and confirmed by pathology were retrospectively analyzed. Results Among the 8 patients, 3 patients showed splenomegaly, 5 patients hadinnumerable lesions, and 3 patients had only a single lesion. The size of the lesions varied from punctate to 68 mm in diameter, and they were rounded nodules in shape. The majority(5/8) of the lesions demonstrated well circumscribed border, with some lesions(3/8) demonstrating a less distinct border. None of the lesions contained any calcification or capsule. On CT,All the lesions presented low-density nodules on CT plain scan, and after enhancement, 3 cases presented progressive enhancement in the venous phase, 4 cases presented obvious enhancement in the arterial phase and washout in the portovenous phase. On MRI,all the lesions demonstrated T2-hyperintense signalsand delayed progressive enhancement. On PET/CT,The radioactive distribution showed scattering in 1 case, andanother showed normalappearance. On US,1 case displayed heterogenousechogenecity in the spleen;2 cases showed hypoechogenicity in spleen with Doppler flow signal. 3 cases showed hyperechogenicity in the spleen without vascularity. Conclusion As a rare benigntumor, Littoral cell angiomaoften has multiple lesions with atypical clinical characteristics. Some of them have splenomegalyand/or hypersplenism, and the imaging findings are similar to hemangioma in characteristics. Imaging examination can detecet the tumor blood supply, and the diagnosis depends on postoperative or puncture pathology and immunohistochemical examination.