CAJ | 학술논문

脾脏原发性血管肉瘤罕见且预后极差，临床虽强调早确诊、早治疗，但其临床表现缺乏特异性，易于误诊，现阶段临床确诊主要依靠手术全切脾脏后组织病理学检测。为提升诊断效果，临床应探讨脾脏原发性血管肉瘤的一般表现并找到可靠的诊断方案。本研究以1例手术病理诊断确诊患者为研究对象，重点探讨免疫组化技术在该疾病诊断中的价值。该病例行影像学检测可见脾脏内多发性实性占位，CT于增强后明显强化，手术标本肉眼观察（巨检）及镜检均有一定特征，行免疫组化反应可见FⅧRag（+）、CD34（+++）、CD31（+++）、Vim（+++）、SMA（局灶+），其免疫组化特征可与上皮样血管内皮细胞瘤、脾窦岸细胞血管瘤等疾病有效区分，有助于指导临床诊断。
비장원발성혈관육류한견차예후겁차，림상수강조조학진、조치료，단기림상표현결핍특이성，역우오진，현계단림상학진주요의고수술전절비장후조직병이학검측。위제승진단효과，림상응탐토비장원발성혈관육류적일반표현병조도가고적진단방안。본연구이1례수술병리진단학진환자위연구대상，중점탐토면역조화기술재해질병진단중적개치。해병례행영상학검측가견비장내다발성실성점위，CT우증강후명현강화，수술표본육안관찰（거검）급경검균유일정특정，행면역조화반응가견FⅧRag（+）、CD34（+++）、CD31（+++）、Vim（+++）、SMA（국조+），기면역조화특정가여상피양혈관내피세포류、비두안세포혈관류등질병유효구분，유조우지도림상진단。
Primary splenic angiosarcoma is extremely rare and prognosis is poor,because of lacking specific clinical manifestations even clinical treatment focused on early diagnosis is easy to misdiagnosis,present diagnosis stage mainly depends on operation after total resection of spleen tissue pathology detection.In order to improve the effect of clinical diagnosis,it should discuss the general performance of primary splenic angiosarcoma and find a reliable diagnosis scheme.In this study,1 cases with pathologic diagnosis confirmed patients was selected as the research object,mainly to discuss the diagnosis value of immunohistochemical technique.Detection of visible in spleen of multiple solid space oc-cupying this image of CT patients,obviously enhancement,macroscopic observation(giant check) and operation specimens giant examination had certain features,immunohistochemical reaction of visible FⅧRag(+),CD34(+++),CD31(+++),Vim (+++),SMA (focal+),the immunohistochemical features can effectively discriminate and epithelioid hemangioendothe-lioma,littoral cell angioma and other diseases,which may help to guide clinical diagnosis.