Splenic cord capillary hemangioma と最終診断しえた脾臓腫瘍の1例  [in Japanese] A Case of Splenic Cord Capillary Hemangioma  [in Japanese]

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Abstract

症例は35歳の女性で,2007年9月中旬頃から38℃前後の発熱,筋肉痛,関節痛を繰り返すため,同年10月上旬当院内科を受診した.血液生化学的検査で軽度の肝機能異常を認めたためCTを施行したところ,最大径約3 cm大の脾臓腫瘍を認めた.入院後,全身精査で他臓器に悪性腫瘍を指摘しえず,原発性脾臓腫瘍を疑い,同年11月腹腔鏡下脾臓摘出術を施行した.手術時間は80分,出血量は20 mlであった.脾臓摘出のための創部を最小限に収めるために,Endocatch II<sup>TM</sup>に収納したうえで3分割後体外に摘出した.肉眼検査所見では被膜を有さない比較的境界明瞭な3×2.5 cmの結節性病変であった.病理組織学的検査において,腫瘍は赤脾髄の脾索性毛細血管の増殖からなり,その形態学的特徴と免疫組織学的検索での特徴としてCD34陽性,CD8陰性,第VIII因子関連抗原(以下,Factor VIII)陰性の増殖内皮細胞の性状であったことから,過誤腫に包括されているsplenic cord capillary hemangiomaと診断した.本症は過誤腫の中でも非常にまれと推察され,自験例が本邦1例目であり報告する.

We report a very rare case of splenic hamartoma. A 35-year-old woman with a 38°C fever, myalgia, and arthralgia since September 2007 was seen in October 2007, at which time she underwent computed tomography (CT) to clarify slight liver-function abnormalities. She was found to have a 3 cm splenic tumor, but detailed systemic postadmission examinations indicated no malignancy of other organs. We conducted laparoscopic splenectomy in November for a suspected primary splenic tumor. The operation took 80 minutes and blood loss was 20 mL. To minimize the spleen removal incision, we placed the spleen in an Endo CatchII<sup>TM</sup>, where it was divided into three segments prior to extraction. The excised specimen showed relatively well-demarcated, uncovered 3×2.5 cm nodular lesions that were found in histopathological examination to be proliferated splenic cord capillaries in the red pulp. Immunostaining was positive for CD34 and negative for CD8 and factor VIII. Morphology and immunophenotypic studies yielded a diagnosis of splenic cord capillary hemangioma classified as splenic hamartoma.

Journal

  • The Japanese Journal of Gastroenterological Surgery

    The Japanese Journal of Gastroenterological Surgery 42(12), 1819-1825, 2009-12-01

    The Japanese Society of Gastroenterological Surgery

References:  20

Cited by:  3

Codes

  • NII Article ID (NAID)
    110007482810
  • NII NACSIS-CAT ID (NCID)
    AN00192066
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869768
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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