脾脏窦岸细胞血管瘤1例并文献复习

A Case of Spleen Littoral Cell Angioma and the Literatures Review

目的探讨脾脏窦岸细胞血管瘤的临床病理特征、鉴别诊断、治疗及预后。方法回顾性分析1例脾脏窦岸细胞血管瘤的临床病史资料、病理学特征及免疫组化表型,并复习相关文献。结果患者为中老年女性,组织学上脾脏内暗红色结节由大小不一、相互吻合的血管腔构成,衬覆单层扁平或高柱状内皮细胞,内皮细胞无异型性。免疫表型:内皮细胞CD31、F8、CD68均阳性,CD8、CD21均阴性,CD34扁平内皮细胞阳性、高柱状内皮细胞阴性,Ki-67增殖指数约4%。结论脾脏窦岸细胞血管瘤是发生于脾脏的罕见特殊类型血管源性肿瘤,临床表现及影像学检查均不典型,术前诊断困难,主要依靠术后病理形态特征及免疫组化检查。

Objective To explore the clinicopathological feature,differential diagnosis,treatment and prognosis of the spleen littoral cell angioma.Methods Retrospectively analyzed the clinical history dates,pathological features and immunohistochemical phenotype of one case of spleen littoral cell angioma,and reviewed the related literatures.Results The patient was middle and aged women.Histologically,the dark red nodules in the spleen were composed of anastomosing blood vessels with uneven size,the vessel lumen was lined by flat or tall columnar endothelial cells which were free from atypia.Immunohistochemical phenotype:The endothelial cells were positive for CD31,F8,and CD68,negative for CD8 and CD21,while the CD34 was expressed on the flat endothelial cells but not the tall columnar cells.The ki-67 labeling index was about 4%.Conclusion The spleen littoral cell angioma is a rare and special kind of vascular tumor which is happened in the spleen.Because of the atypical characteristic of clinic feature and image examination,it is difficult to be diagnosed accurately pre-operation,and the spleen littoral cell angioma is diagnosed mainly depended on the pathological morphological features and immunohistochemical examination.