Histologically classified venous angiomas of the brain: a controversy
Histologically classified venous angiomas of the brain: a controversy
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DOI：
10.2176/nmc.43.1
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发表时间：
2003-01-01
影响因子：
1.9
通讯作者：
Miyasaka, Y
中科院分区：
文献类型：
--
作者：
Abe, M;Hagihara, N;Miyasaka, Y
“静脉血管瘤”（VA）一词通常是指发育性静脉异常（DVA）。然而，一组称为VAs的血管畸形在血管造影上没有显示静脉异常。我们研究了8例出现出血或癫痫发作的患者的临床和组织学特征，以重新评估这些静脉异常。6例患者血管造影未见静脉异常。组织学研究包括平滑肌肌动蛋白和胶质纤维酸性蛋白的免疫染色。对10例海绵状血管瘤、10例动静脉畸形和2例毛细血管扩张的手术标本进行比较。手术安全地切除了血管造影上隐匿的VAs，而DVAs的切除则伴有脑肿胀和出血性脑梗死。组织学检查发现血管造影隐匿性输精管含有畸形和紧密排列的血管，部分壁变性，而dva有扩张的薄壁血管，弥漫性分布在正常白质中。本研究对我们的病例和对已报道的VAs病例的回顾表明，两种不同的临床和病理实体通常被归类为“VA”，血管造影隐匿性VAs和DVAs。这两个实体应该仔细区分。
The term "venous angioma" (VA) usually refers to a developmental venous anomaly (DVA). However, a group of vascular malformations called VAs shows no venous abnormalities on angiography. The clinical and histological features of histologically classified VAs were studied in eight patients who presented with hemorrhage or seizures to reevaluate these venous anomalies. Angiography showed no venous abnormalities in six patients. Histological study included immunostaining for smooth muscle actin and glial fibrillary acidic protein. Surgical specimens of 10 cases of cavernous angiomas, 10 cases of arteriovenous malformations, and two cases of capillary telangiectasias were studied to compare these types of VAs. Angiographically occult VAs were surgically removed safely, whereas removal of DVAs was complicated by brain swelling and hemorrhagic infarction of the brain. Histological examination found angiographically occult VAs contained malformed and compactly arranged vessels with partly degenerated walls, whereas DVAs had dilated thin-walled vessels that were diffusely distributed in the normal white matter. This study of our cases and a review of the reported cases of VAs suggests that two different clinical and pathological entities are commonly categorized as "VA," angiographically occult VAs and DVAs. These two entities should be carefully distinguished.