原发性脾血管肉瘤1例报告

王慧君; 牛剑祥; 徐晓艳; 郑卫华; 李朋飞; 刘一博; 张俊晶

doi:10.3969/j.issn.1001-5256.2021.11.036

原发性脾血管肉瘤1例报告

DOI: 10.3969/j.issn.1001-5256.2021.11.036

1.
内蒙古医科大学附属医院肝胆胰脾外科，呼和浩特 010050
2.
内蒙古医科大学病理学教研室，呼和浩特 010030
3.
呼和浩特市第一医院肝胆胰脾外科，呼和浩特 010030

基金项目:

内蒙古自治区草原英才培养专项基金资助项目 (CYYC2012040)

详细信息

通信作者:
张俊晶，zhang.jj@vip.163.com

中图分类号: R733.2
计量
- 文章访问数: 280
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-30
- 录用日期: 2021-05-06
- 出版日期: 2021-11-20

A case of primary splenic angiosarcoma

1.
Department of Hepatobiliary, Pancreatic, and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
2.
Department of Pathology, Inner Mongolia Medical University, Hohhot 010030, China
3.
Department of Hepatobiliary, Pancreatic, and Splenic Surgery, Hohhot First Hospital, Hohhot 010030, China

Research funding:

Inner Mongolia Autonomous Region Grassland Talent Cultivation Special Fund Project (CYYC2012040)

摘要

- 脾肿瘤 /
- 血管肉瘤 /
- 治疗学
- Splenic Neoplasms /
- Hemangiosarcoma /
- Therapeutics

HTML全文

图 1 术前全腹增强CT检查结果

注：门静脉期见肝脾内弥漫分布小结节状低强化影，周围见液体密度影。

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图 2 骨髓穿刺病理学检查结果

注：a，HE染色(×400)；b，骨髓见梭形细胞，稍有异型，可见血管腔隙，CD34(+)(免疫组化，×400)。

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图 3 术中腔镜视野

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图 4 术后病理学检查结果

注：a，脾内未见皮质、髓质结构，可见残存脾小梁(蓝色箭头)，视野中见大量增生的肿瘤细胞，多排列为裂隙样，部分见坏死(红色箭头) (HE染色，×100)；b，分化较好部位，肿瘤细胞有一定异型性，部分呈鞋钉样，可见血管腔隙(HE染色，×400)；c：分化较差部位肿瘤细胞呈梭形，有一定异型性，呈束状、片状排列，可见裂隙，其内可见一脾小动脉(红色箭头)(HE染色，×400)；d：Ki-67热点区域(15%+)(免疫组化，×400)；e：肿瘤细胞弥漫CD31(+)(免疫组化，×400)；f：肿瘤细胞弥漫FLi1 (+)(免疫组化，×400)。

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参考文献(24)

[1]	LI R, LI M, ZHANG LF, et al. Clinical characteristics and prognostic factors of primary splenic angiosarcoma: A retrospective clinical analysis from China[J]. Cell Physiol Biochem, 2018, 49(5): 1959-1969. DOI: 10.1159/000493656.
[2]	ZHANG ZY, CHENG YJ, GONG XL, et al. Characteristics and outcomes of primary angiosarcoma[J]. Chin J Oncol, 2019, 41(9): 693-697. DOI: 10.3760/cma.j.issn.02533766.2019.09.009. 张智旸, 程月鹃, 公小蕾, 等. 原发性血管肉瘤的临床特征和预后分析[J]. 中华肿瘤杂志, 2019, 41(9): 693-697. DOI: 10.3760/cma.j.issn.02533766.2019.09.009.
[3]	CAO L, HONG J, WANG Y, et al. A primary splenic angiosarcoma hepatic metastasis after splenectomy and its genomic alteration profile[J]. Medicine (Baltimore), 2019, 98(28): e16245. DOI: 10.1097/MD.0000000000016245.
[4]	YANG KF, LI Y, WANG DL, et al. Primary splenic angiosarcoma with liver metastasis: A case report and literature review[J]. World J Gastroenterol, 2016, 22(12): 3506-3510. DOI: 10.3748/wjg.v22.i12.3506.
[5]	BATOULI A, FAIRBROTHER SW, SILVERMAN JF, et al. Primary splenic angiosarcoma: Clinical and imaging manifestations of this rare aggressive neoplasm[J]. Curr Probl Diagn Radiol, 2016, 45(4): 284-287. DOI: 10.1067/j.cpradiol.2015.07.004.
[6]	CHEN F, JIN HF, FAN YH, et al. Case report of primary splenic angiosarcoma with hepatic metastases[J]. World J Gastroenterol, 2015, 21(39): 11199-11204. DOI: 10.3748/wjg.v21.i39.11199.
[7]	DENG R, CHANG W, WU X, et al. Primary splenic angiosarcoma with fever and anemia: A case report and literature review[J]. Int J Clin Exp Pathol, 2015, 8(11): 14040-14044.
[8]	MYOTERI D, DESPOINA M, DELLAPORTAS D, et al. Primary angiosarcoma of the spleen: An oncological enigma[J]. Case Rep Oncol Med, 2014, 2014: 193036. DOI: 10.1155/2014/193036.
[9]	CHEN X, LI H, WANG F, et al. Early detection and integral resection are keys to extend survival in patients suffered from primary angiosarcoma of the spleen: A care-compliant case report and literature review[J]. Medicine (Baltimore), 2018, 97(5): e9718. DOI: 10.1097/MD.0000000000009718.
[10]	THIPPHAVONG S, DUIGENAN S, SCHINDERA ST, et al. Nonneoplastic, benign, and malignant splenic diseases: Cross-sectional imaging findings and rare disease entities[J]. AJR Am J Roentgenol, 2014, 203(2): 315-322. DOI: 10.2214/AJR.13.11777.
[11]	THOMPSON WM, LEVY AD, AGUILERA NS, et al. Angiosarcoma of the spleen: Imaging characteristics in 12 patients[J]. Radiology, 2005, 235(1): 106-115. DOI: 10.1148/radiol.2351040308.
[12]	LI H, ZHOU ZQ, LIU B, et al. A case of primary splenic angiosarcoma[J]. Chin J Pathol, 2003, 32(4): 91. DOI: 10.3760/j.issn:0529-5807.2003.04.026. 李红, 周志强, 刘滨, 等. 原发性脾脏血管肉瘤一例[J]. 中华病理学杂志, 2003, 32(4): 91. DOI: 10.3760/j.issn:0529-5807.2003.04.026.
[13]	CHEN M, ZHA YF, WANG YY, et al. CT findings of primary splenic angiosarcoma and literature review[J]. J Pract Radiol, 2019, 35(1): 159-161. DOI: 10.3969/j.issn.1002-1671.2019.01.041. 陈明, 查云飞, 王艳艳, 等. 原发性脾血管肉瘤CT表现并文献复习[J]. 实用放射学杂志, 2019, 35(1): 159-161. DOI: 10.3969/j.issn.1002-1671.2019.01.041.
[14]	SILECCHIA G, BORU CE, FANTINI A, et al. Laparoscopic splenectomy in the management of benign and malignant hematologic diseases[J]. JSLS, 2006, 10(2): 199-205.
[15]	de AZEVEDO OS, do NASCIMENTO SANTOS B, de SOUZA LIBONI N, et al. Splenic angiosarcoma: A diagnostic splenectomy finding[J]. Case Rep Oncol, 2016, 9(3): 733-737. DOI: 10.1159/000452619.
[16]	HARA T, TSURUMI H, KASAHARA S, et al. Long-term survival of a patient with splenic angiosarcoma after resection, high-dose chemotherapy, and autologous peripheral blood stem cell transplantation[J]. Intern Med, 2010, 49(20): 2253-2257. DOI: 10.2169/internalmedicine.49.3969.
[17]	VAKKALANKA B, MILHEM M. Paclitaxel as neoadjuvant therapy for high grade angiosarcoma of the spleen: A brief report and literature review[J]. Clin Med Insights Oncol, 2010, 4: 107-110. DOI: 10.4137/CMO.S5329.
[18]	RUPOLO M, BERRETTA M, BUONADONNA A, et al. Metastatic angiosarcoma of the spleen. A case report and treatment approach[J]. Tumori, 2001, 87(6): 439-443. DOI: 10.1159/000050642.
[19]	ALEXANDRINO H, JULIÃO MJ, TRALHVÃO JG, et al. Rupture of splenic angiosarcoma: A rare cause of spontaneous haemoperitoneum[J]. BMJ Case Rep, 2013, 2013: bcr2013009748. DOI: 10.1136/bcr-2013-009748.
[20]	ASMANE I, LITIQUE V, HEYMANN S, et al. Adriamycin, cisplatin, ifosfamide and paclitaxel combination as front-line chemotherapy for locally advanced and metastatic angiosarcoma. Analysis of three case reports and review of the literature[J]. Anticancer Res, 2008, 28(5B): 3041-3045. DOI: 10.1097/CAD.0b013e32830c2380.
[21]	LIST AF. Lenalidomide-the phoenix rises[J]. N Engl J Med, 2007, 357(21): 2183-2186. DOI: 10.1056/NEJMe078203.
[22]	CLIFFORD CA, MACKIN AJ, HENRY CJ. Treatment of canine hemangiosarcoma: 2000 and beyond[J]. J Vet Intern Med, 2000, 14(5): 479-485. DOI: 10.1892/0891-6640(2000)014<0479:tochab>2.3.co;2.
[23]	NAKA N, OHSAWA M, TOMITA Y, et al. Prognostic factors in angiosarcoma: A multivariate analysis of 55 cases[J]. J Surg Oncol, 1996, 61(3): 170-176. DOI: 10.1002/(SICI)1096-9098(199603)61:3<170::AID-JSO2>3.0.CO;2-8.
[24]	HSU JT, UENG SH, HWANG TL, et al. Primary angiosarcoma of the spleen in a child with long-term survival[J]. Pediatr Surg Int, 2007, 23(8): 807-810. DOI: 10.1007/s00383-007-1874-1.