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The Korean Journal of Pathology 2010;44(5): 502-512.
doi: https://doi.org/10.4132/KoreanJPathol.2010.44.5.502
Primary Splenic Vascular Lesions: A Clinicopathologic, Immunophenotypic and Radiopathologic Correlation Study of 40 Cases.
Young Wha Koh, Heejin Lee, Gawon Choi, Gui Young Kwon, Eun Ju Kim, Jooryung Huh
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jrhuh@amc.seoul.kr
2Department of Pathology, Mizmedi Hospital, Seoul, Korea.
3Department of Pathology, Chung-Ang University Hospital, Chung-Ang School of Medicine, Seoul, Korea.
BACKGROUND: Primary splenic vascular lesions include the tumor and the inflammatory condition. A primary splenic vascular tumor is rare but is the most common tumor of the benign primary splenic tumors. METHODS: We describe the clinicopathological, radiological, and immunophenotypical findings of 40 cases of primary vascular lesions identified at our hospital from 1996 to 2009. RESULTS: The patients included 18 men and 22 women, aged 12 to 74 years, with a mean of 43.3-years and median of 40-years. They comprised 14 hemangiomas (35%), 13 lymphangiomas (32.5%), three hamartomas (7.5%), three littoral cell angiomas (7.5%), three sclerosing angiomatoid nodular transformations (SANT, 7.5%) and four angiosarcomas (10%). The majority of the patients (65%) were asymptomatic. Some of the patients (32.5%) complained of abdominal pain, and 2.5% of the patients presented with fever. Metastases were identified in 75% of the patients with an angiosarcoma at the initial work-up. One angiosarcoma patient died of the disease despite adjuvant chemoradiotherapy. The radiological findings for hamartoma, littoral cell angioma, and SANT were nonspecific. Microscopically, six types of vascular lesions showed classic morphological and immunophenotypical features of their type. CONCLUSIONS: One should be aware of rare splenic vascular lesions when radiological findings are nonspecific. Histomorphological and immunophenotypical features are helpful for the differential diagnosis.
Key Words: Spleen; Vascular lesion