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[胰腺淋巴上皮囊肿:诊断困难。附两例报告]

[Lympho-epithelial cyst of the pancreas: a difficult diagnosis. About two cases].

作者信息

Chatelain Denis, Couvelard Anne, Hammel Pascal, Terris Benoît, Palazzo Laurent, Verhaeghe Pierre, Belghiti Jacques, Fléjou Jean-François

机构信息

Service d'Anatomie Pathologique, Hôpital Saint-Antoine, Paris, France.

出版信息

Gastroenterol Clin Biol. 2002 Oct;26(10):935-8.

Abstract

We report two cases of lymphoepithelial cyst of the pancreas discovered incidentally on imaging in two men aged 50 and 61 years. One cyst contained hyperdense spots on CT-scan and in this case the biochemical analysis of the cyst fluid revealed high level of CEA. The unilocular cysts measured 4 and 5 cm on the surgical specimen. On microscopic examination, the cysts were lined by squamous keratinized epithelium positive for CEA, with rare mucin-secreting cells, lining on lymphoid tissue. The lymphoepithelial cyst is a rare dysembryoplastic benign lesion of the pancreas difficult to diagnose before surgery. The presence of keratin plugs on imaging is inconstant and the biochemical analysis of the cyst fluid can mislead to a diagnosis of mucinous cystic tumour. Cytological and histological analysis of fine needle aspiration material is of diagnostic interest and can avoid surgical resection when patients are symptom-free.

摘要

我们报告了两例胰腺淋巴上皮囊肿病例,这两例均在影像学检查时偶然发现,患者分别为50岁和61岁男性。其中一个囊肿在CT扫描上显示有高密度斑点,该病例中囊肿液的生化分析显示癌胚抗原(CEA)水平较高。手术标本上的单房囊肿大小分别为4厘米和5厘米。显微镜检查显示,囊肿内衬鳞状角化上皮,CEA呈阳性,有罕见的黏液分泌细胞,内衬于淋巴组织。胰腺淋巴上皮囊肿是一种罕见的发育异常性胰腺良性病变,术前难以诊断。影像学上角质栓的出现并不恒定,囊肿液的生化分析可能会导致误诊为黏液性囊性肿瘤。细针穿刺材料的细胞学和组织学分析具有诊断价值,对于无症状患者可避免手术切除。

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