背景:目前的研究旨在研究临床特征,鉴别诊断,和治疗脾沿岸细胞血管瘤(LCA)。
方法:对湖州市中心医院2007-2023年收治的10例LCA患者的临床表现进行回顾性分析。血液学检查,成像特征,病理特征,治疗方法,并对预后及相关文献进行了综述。
结果:在检查期间,10例LCA均未见特异性临床表现和血液学异常。成像观察描绘了脾脏中的单个或甚至多个球形病变。发现计算机断层扫描(CT)显示的平原的密度稍相等或略低。另一方面,磁共振成像(MRI)平扫,即.T1加权图像显示相等的低和混合信号,而T2加权显示高和低混合信号。此外,在MRI扫描中,在名为“雀斑体征”的高信号中可以看到点状低信号。在对比增强CT扫描中,病变在动脉期增强不明显,一些病变在静脉期和延迟期显示边缘环状增强和“填充湖”进行性增强。在多发性病变中,增强扫描病变的数量显示出可变的变化模式\“少-多-少”。“MRI增强扫描显示\”快进慢出的特点。“显微镜检查发现肿瘤组织实际上是由鼻窦状腔隙组成的,这些腔隙以网络的形式相互吻合。此外,在扩张的窦腔中也观察到囊性扩张和假乳头状突起,窦腔内衬单层内皮细胞,具有明显的细胞质含铁血黄素。还观察到血管内皮细胞表型(CD31,CD34,FVIII)和组织细胞表型(CD68)的高免疫表型表达。全脾和部分脾切除8例,2例,分别,随访检查显示,所有患者均无复发。
结论:LCA是一种罕见的脾脏良性病变,临床表现不典型。CT和MRI成像是基于病理形态学和免疫组织化学检查的术前诊断的重要工具。脾切除术是一种优越的治疗选择,具有重要的影响和预后。
BACKGROUND: Current study aimed to investigate the clinical characterization, differential diagnosis, and treatment of splenic littoral cell angioma (LCA).
METHODS: A retrospective analysis was performed for 10 LCA cases admitted to Huzhou Central Hospital from 2007 to 2023, for clinical manifestations, hematological tests, imaging features, pathological features, treatment methods, and prognosis along with the relevant literature was also reviewed.
RESULTS: During examinations, no specific clinical manifestations and hematological abnormalities were seen in all 10 cases of LCA. Imaging observations depicted single or even multiple spherical lesions in the spleen. Plains shown by computed tomography (CT) were found somewhat equal or slightly lower in density. On the other hand, magnetic resonance imaging (MRI) plain scans viz. T1 weighted image showed equal low and mixed signals while T2-weighted showed high and low mixed signals. Moreover, punctate low signals could be seen in high signals named \"freckle sign\" in MRI scans. On contrast-enhanced CT scans, the enhancement of the lesions was not obvious in the arterial phase, and some of the lesions showed edged ring-like enhancements and \"filling lake\" progressive enhancement during the venous phase and delayed phase. In multiple lesions, the number of enhanced scan lesions showed a variable changing pattern \"less-more-less.\" MRI-enhanced scan showed the characteristics of \"fast in and slow out.\" Microscopic examinations identified tumor tissue actually composed of sinus-like lacunae that anastomosed with each other in the form of a network. Furthermore, cystic expansion and pseudopapillary protrusions were also seen in the dilated sinus cavity which was lined with single-layer endothelial cells having conspicuous cytoplasmic hemosiderin. High immunophenotypic expressions of vascular endothelial cell phenotype (CD31, CD34, FVIII) and tissue cell phenotype (CD68) were also seen. Total and partial splenectomy were performed in 8 and 2 patients, respectively, and follow-up examinations showed survival in all patients with no recurrence.
CONCLUSIONS: LCA is a rare splenic benign lesion with atypical clinical manifestations. CT and MRI imaging are important tools in preoperative diagnosis based on pathomorphological and immunohistochemical examinations. Splenectomy is a superior therapeutic choice with significant impacts and prognosis.