Caillot J L, Rongieras F, Voiglio E, Isaac S, Neidhardt J P
Department of Surgical Emergency, Lyon-Sud University Hospital, Pierre-Bénite, France.
Hepatogastroenterology. 2000 Jul-Aug;47(34):916-8.
A new case of congenital cyst of the pancreas is reported. A 34-year-old woman was admitted with a painless, large, epigastric mass. Ultrasonography revealed an anechogenic retrogastric tumor. Computed tomography scan described a liquid cyst of the pancreas which was 15 cm in diameter. During surgery, a well-delimited translucent cyst was found and no local malignancy was observed. Extensive distal pancreatic resection with preservation of the spleen was performed and a thin part of cephalic pancreas was preserved. The liquid of the cyst did not contain any mucus. Microscopic study of the cyst wall described normal cuboidal cells and congenital cyst of the pancreas was diagnosed. Several diagnoses including hydatid cyst, pseudocyst and cystic tumors of the pancreas are discussed. Before surgery, lack of acute pancreatitis in recent medical history rules out pseudocyst and hydatid cyst. During the operation, if cystadenocarcinoma is easily ruled out, macrocystic serous cystadenoma is more difficult to exclude. Only histological examination of the cystic wall confirms the difference between cystadenoma and congenital cyst which remains an exceptional entity.
本文报告了一例新的先天性胰腺囊肿病例。一名34岁女性因上腹部无痛性巨大肿块入院。超声检查显示胃后无回声肿瘤。计算机断层扫描显示一个直径为15厘米的胰腺液性囊肿。手术中发现一个界限清晰的半透明囊肿,未观察到局部恶性病变。进行了广泛的胰腺远端切除术并保留了脾脏,同时保留了胰头的一小部分。囊肿液中未含有任何黏液。对囊肿壁进行显微镜检查发现为正常立方细胞,诊断为先天性胰腺囊肿。文中讨论了包括包虫囊肿、假性囊肿和胰腺囊性肿瘤在内的几种诊断。术前,近期病史中无急性胰腺炎可排除假性囊肿和包虫囊肿。手术过程中,若能轻易排除囊腺癌,则大囊型浆液性囊腺瘤更难排除。只有对囊肿壁进行组织学检查才能确认囊腺瘤与先天性囊肿之间的差异,而先天性囊肿仍然是一种罕见的病症。