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目的探讨脾血管内皮细胞瘤的临床病理学特征、诊断及鉴别诊断要点。方法报道3例罕见的脾血管内皮细胞瘤,结合文献对其临床表现、组织形态、免疫组化及治疗预后进行分析。结果男性1例,女性2例,年龄27～51岁,平均年龄35岁。患者因影像学检查示脾占位就诊。大体观察均为局限单个边界清楚肿物。镜下均可见大量血管内皮泡沫样细胞、血管增生及扩张。免疫组化:CD31和CD34(+),CD68局部(+),SMA(■),CK(-)。结论脾上皮样血管内皮细胞瘤是一种罕见的肿瘤,确诊需依靠病理检查及免疫组化,具有细胞内血管腔的上皮样瘤细胞并呈血管内皮标记物阳性是该病病理诊断的两个重要特征。需同脾其他肿瘤鉴别。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of splenic vascular endothelial tumor. Methods Three cases of rare splenic angio-endothelial cell tumor were reported. Their clinical manifestations, histomorphology, immunohistochemistry and prognosis were analyzed in combination with the literature. Results 1 males and 2 females, aged 27 to 51 years, mean age 35 years. Patients due to imaging showed spleen accounting treatment. Gross observation is limited to a single boundary clear tumor. Microscope can be seen a large number of vascular endothelial foam-like cells, vascular proliferation and expansion. Immunohistochemistry: CD31 and CD34 (+), CD68 local (+), SMA (■), CK (-). Conclusions Splenic epithelioid hemangioendothelioma is a rare tumor. The diagnosis depends on pathological examination and immunohistochemistry. Epithelioid tumor cells with intravascular lumen and positive vascular endothelial markers are two of the pathological diagnosis Important features. Need to identify with other spleen tumors.