肠道血管肉瘤6例临床病理分析OA

Objective To investigate the clinicopathological characteristics of intestinal angiosarcoma(AS)and explore the challenges in preoperative diagnosis.Methods Clinical symptoms,imaging findings,endoscopic fea-tures,and pathological data were retrospectively analyzed in 6 patients with intestinal AS.Results All 6 patients were male,aged 32-80 years,including 2 primary and 4 metastatic tumors.The predominant symptoms were ab-dominal pain and distension(4/6).CT scans showed bowel wall thickening in all cases(6/6),with marked enhance-ment in 2(2/6).Solitary and multifocal lesions were equally distributed(3 cases each).The colon was involved in 5 cases and the small intestine in 3.Endoscopically,tumors presented as elevated masses(4/6),pedunculated polyps(1/6),or ulcerative lesions(1/6).Histomorphology was highly variable,exhibiting a spectrum of vascular channel differentiation and cellular atypia,which could mimic benign vascular lesions,fibroblasts,histiocytes,or poorly dif-ferentiated adenocarcinoma.Preoperative biopsy was performed in 4 cases,with pathology reporting no tumor cells in 3(3/4)and poorly differentiated carcinoma in 1(1/4).Immunohistochemistry showed positivity for CD31(6/6),ERG(3/4),CD34(1/6),and CKpan(4/6).Conclusion Intestinal AS is rare and frequently overlooked in clinical practice.Preoperative examination and biopsy-based pathological diagnosis remain challenging.A thorough under-standing of its uncommon manifestations and diagnostic limitations is essential for improving diagnostic accuracy and timeliness.