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Objective To evaluate the clinical features and the key points in the diagnosis and management of splenic hemangioma.Methods The clinical presentations,laboratory tests,imaging and pathological results,treatment,and prognosis of 21 cases of splenic hemangioma admitted in Peking Union Medical College Hospital from April,1989 to July 2007 were retrospectively analyzed.Results The clinical presentations of splenic hemangiom are not specific which include left upper quadrant mass or discomfort,abdominal pain,etc.The diagnosis of imaging includes Doppler ultrasound,CT,MRI,DSA,etc.Splencetomy is recommended for all splenic hemangioma with severe symptoms or rupture.Conclusion Asymptomatic patients with small splenic hemangioma(＜4 cm)can be managed conservatively.Symptomatic large hamangioma may need a sp]enectomy.
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Objective To investigate the clinicopathologic features,diagnosis,differential diagnosis and treatment of sclerosing angiomatoid nodular transformation(SANT). Methods The clinical data,pathologic characteristics,immunophenotype and postoperative follow-up of SANT were analysed. Results There were no specific findings in the clinical manifestations of the 4 cases of SANT.Grossly,the cut surface of the masses was gray-white and vague nodularity was observed.Microscopically,it was characterized by the multinodular angiomatoid appearance in a fibrosclerotic stroma.The nodules were composed of slit-like,sinusoid-like vascular spaces and were interspersed with a population of spindly or ovoid cells.It was revealed by immunohistochemistry that the expression of CD34 in some vessels' endothelial cells was positive,and CD8 was negative.While in another vessels' endothelial cells,CD8 was positive and CD34 was negative.The expression of SMA,Actin,Vimentin,Collage IV and CD68 was positive in all of the 4 cases,while that of CD21,Desmin and NSE was negative.No relapse or metastasis was found during the follow-up.Conclusion SANT is a rarely encountered benign lesion of the spleen,which should be distinguished from the malignant tumor of the spleen.The diagnosis counts on the pathologic and immunohistochemical findings.It could be cured by splenectomy with a favourable prognosis.
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Objective To evaluate the operation of laparoscopic splenectomy(LS),its safety and clinical effects.Methods Literature of the advances of LS were reviewed and analyzed.Results With the development of technology and surgical technique,the indications for LS were widened,the size of spleen plays an important role in the clinical outcome of LS.Conclusion LS has all the advantages of minimally invasive surgery.The application of hand-assisted technique is safe and feasible for giant spleen.With the accumulation of surgical experiences and technique development,LS will be extensively used in clinic.
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Objective To evaluate the feasibility and efficacy of laparoscopic splenectomy(LS). Methods In this study 41 cases were enrolled including 10 cirrhotic splenomegaly cases and 17 idiopathic thrombocytopenic purpura cases. The clinical data of 41 cases undergoing LS was retrospectively reviewed. KG2Result Two cases were shifted to open surgery, LS was successful in 39 cases with average operating time of 238 min, the average spleen weight was 389 g, blood loss 318 ml, postoperative GI movement started from 12 to 24 hrs. The average postoperative hospital stay was 4 days. Postoperative complications occurred in 3 cases including intraabdominal bleeding, subcutaneous emphysema, and stabbing-caused abdominal wall bleeding in one each. Conclusion LS is safe and less traumatic in selected patients indicated for splenectomy, especially for those suffering from haemotologic diseases.
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Nonparasitic true splenic cyst is a rare disease and the epidermoid cyst accounts for the majority of the cases. And the epidermoid cyst producing CA19-9 is extremely rare. We present a case of true splenic cyst with high cystic fluid CA19-9 level. A 26-year-old woman complained left upper quadrant abdominal pain. Abdominal ultrasonography and CT depicted a 17 x 13 cm sized cystic lesion in the left upper abdomen. The aspirated cystic fluid showed high concentration of CA19-9, but serum CA19-9 level was normal. Spleen with huge unilocular cyst was removed surgically. The cyst was lined with single layered cuboidal epithelial cells and negative for immunohistochemical staining with anti-CA19-9 antibody.