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April 30, 2026The Japanese Journal of Gastroenterological Surgery0 citationsOpen Access

A Case of Laparoscopic Splenectomy for Sclerosing Angiomatoid Nodular Transformation of the Spleen

SYS YamamotoKMKentaro MiyakeKYKizuki Yuza

Key Points

  • This case aims to highlight the diagnosis and surgical treatment of SANT through laparoscopic splenectomy.
  • A 51-year-old male was evaluated for splenomegaly via contrast-enhanced ultrasound and CT, revealing a 55 mm lesion.
  • A laparoscopic splenectomy was performed for definitive diagnosis and treatment of suspected SANT.
  • Histopathological and immunohistochemical analyses confirmed the diagnosis of SANT.
  • The lesion was diagnosed as SANT based on histopathology showing irregular vascular lumens amid collagen-rich tissue.
  • Immunohistochemical analysis revealed positive staining for CD34, CD31, and CD8.
  • Successful laparoscopic splenectomy resulted in an accurate diagnosis and removal of the vascular lesion.

Abstract

症例は51歳の男性で，健診の腹部エコーで脾腫瘤を指摘され精査目的に当科紹介受診した．腹部造影エコー，造影CTで脾臓に55 mm大の車輻様の造影効果を伴う腫瘤を認めた．造影MRIではT2*WIでヘモジデリン沈着を疑う低信号域を認めた．脾sclerosing angiomatoid nodular transformation（以下，SANTと略記）を第一に疑い，確定診断目的に腹腔鏡下脾臓摘出術を施行した．病理組織学的検査では，腫瘤内部に膠原線維に富んだ結合組織を背景とした不整形の血管腔を多数認めた．免疫組織学的検査ではCD34，CD31，CD8に陽性を示す血管成分の混在を認めSANTと診断した．SANTは術前診断が困難な脾臓の非腫瘍性血管病変であり，確定診断には外科的切除が必要である．

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Cite This Study

Yamamoto et al. (2026) studied this question.

synapsesocial.com/papers/69f2f1471e5f7920c6386fa6https://doi.org/10.5833/jjgs.2024.0112
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