|
|
|
| Imaging features and pathological basis of hepatic and splenic angiosarcoma |
| CHEN You, HE Lai-chang, TAN Yong-ming, ZHAN Ya-ru |
| Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China |
|
|
|
|
Abstract Objective: To investigate the imaging findings and pathological features of hepatic and splenic angiosarcoma and to improve the diagnostic level of imaging. Methods: The clinical and imaging findings of 6 hepatic and splenic angiosarcomas confirmed by operation and pathology were retrospectively analyzed and compared with pathological results. Results: Six cases of hepatic and splenic angiosarcoma occurred in liver(3 cases), spleen(2 cases), both liver and spleen(1 case). One case was single mass type, 1 case was multiple nodular type, 1 case was massive type, 1 case was mixed type, 1 case was diffuse nodular type, and 1 case had no obvious nodule and lump. Among them, T1WI high-signal hemorrhage was found in 2 cases, and 1 case had multiple lesions around the main lesion. In 5 cases of CT/MRI enhanced scan, all of them showed uneven centripetal and delayed enhancement. One case of diffuse nodular type showed nodular and reticular continuous enhancement and filling to the interior, and one case of multiple nodular type showed different nodular signals, the strengthening methods were also different, some of them showed the characteristics of progressive centripetal enhancement, some were ring-shaped enhancement, and the other 3 cases showed uneven centripetal and delayed enhancement of the lesion edge. Pathological findings showed that the tumor cells were mostly strips, epithelioid and nest like, and the vascular lumens of different sizes were anastomosed with each other, and tumor cells grew along the vascular lumen, and some of them showed papillary structures, some of tumors had hemorrhage and necrosis. Conclusion: The hepatic and splenic angiosarcoma usually presents as mixed density/signal mass on plain scan, and cystic change and hemorrhage are common in the lesion. CT/MRI enhanced scanning is of great significance for the diagnosis of angiosarcoma, most of which are annular or irregular enhancement at the edge of the lesion or in the central arterial phase, and centripetal or centrifugal progressive enhancement in the venous and delayed phases.
|
|
Received: 27 May 2019
|
|
|
|
|
|
| [1]Walker EA, Fenton ME, Salesky JS, et al. Magnetic resonance imaging of benign soft tissue neoplasms in adults[J]. Radiol Clin North Am, 2011, 49(6): 1197-1217.
[2]Walker EA, Song AJ, Murphey MD. Magnetic resonance imaging of soft-tissue masses[J]. Semin Roentgenol, 2010, 45(4): 277-297.
[3]史东立，马良，赵大伟，等. 原发性肝脏肉瘤的影像学表现[J]. 实用放射学杂志，2018，34（10）：1538-1541.
[4]Dhanasekar P, Karthikeyan VS, Rajkumar N, et al. Cutaneous angiosarcoma of the scalp masquerading as a squamous cell carcinoma: case report and literature review[J]. J Cutan Med Surg, 2012, 16(3): 187-190.
[5]Sturgis EM, Potter BO. Sarcomas of the head and neck region[J]. Curr Opin Oncol, 2003, 15(3): 239-252.
[6]Young RJ, Brown NJ, Reed MW, et al. Angiosarcoma[J]. Lancet Oncol, 2010, 11(10): 983-991.
[7]张伟，王兰荣，薛鹏，等. 原发性肝血管肉瘤的CT和MRI表现[J]. 临床放射学杂志，2014，33（5）：734-738.
[8]Rao P, Lahat G, Arnold C, et al. Angiosarcoma: a tissue microarray study with diagnostic implications[J]. Am J Dermatopathol, 2013, 35(4): 432-437.
[9]Harris E, Barry M, Kell MR. Meta-analysis to determine if surgical resection of the primary tumour in the setting of stage Ⅳ breast cancer impacts on survival[J]. Ann Surg Oncol, 2013, 20(9): 2828-2834.
[10]刘红山，谢雨恩，李坤芳，等. 原发性肝血管肉瘤的病理与影像学对照[J]. 分子影像学杂志，2017，40（4）：383-387.
[11]王春，章顺壮，马周鹏，等. 肝脏血管肉瘤的多层螺旋CT表现及其相关病理基础[J]. 中华放射学杂志，2011，45（2）：203-204.
[12]李俊，陈瑞莹，张家雄，等. 肝脏血管肉瘤的CT表现及鉴别诊断[J]. 临床放射学杂志，2018，37（6）：968-971.
[13]陈朔，许乙凯，段峰，等. 原发性肝脏血管肉瘤的CT表现与误诊分析[J]. 实用放射学杂志，2015，31（5）：875-877.
[14]唐浩，邹丹凤，张妮，等. 肝脏原发性血管肉瘤的CT表现（附3例报告及文献复习）[J]. 临床放射学杂志，2011，30（10）：1545-1547.
[15]谢晓刚，郑红伟，祁佩红，等. 原发性肝血管肉瘤的CT表现及病理分析[J]. 实用放射学杂志，2013，29（12）：1967-1970. |
|
|
|
