Pereira Arias J G, Ullate Jaime V, Carral Tellítu I, Ateca Díaz-Obregón R, Gutiérrez Díaz J M, Berreteaga Gallastegui J R
Servicio de Urología, Hospital San Eloy, Baracaldo, Vizcaya.
Actas Urol Esp. 2002 Sep;26(8):574-8. doi: 10.1016/s0210-4806(02)72830-1.
Ectopic splenic tissue is uncommon in clinical practice, usually asymptomatic and generally unsuspected diagnosed. Interest from urological point of view is due to the possibility of mimicking left renal, adrenal and retroperitoneal tumours; as well as intrapelvic, inguinal and genital masses. We report a 42-years-old female patient with pseudotumoral upper pole left kidney mass with final diagnosis of ectopic spleen. Ethiopathogenic, diagnostic and therapeutical aspects are briefly reviewed in literature. We emphasized opportunity to include ectopic splenic tissue in differential diagnosis of left renal, adrenal and retroperitoneal masses. We recommend imaging studies as CT and MRI, complemented if necessary with liver/spleen radionuclide scan. We advocate for non-aggressive attitude in selected cases with asymptomatic extrapelvic ectopic spleen under confirmed diagnosis, deferring splenectomy in symptomatic instances or secondary portal hypertension cases.
异位脾组织在临床实践中并不常见，通常无症状，一般也不会被怀疑而确诊。从泌尿外科角度来看，其意义在于可能会被误诊为左肾、肾上腺及腹膜后肿瘤；以及盆腔内、腹股沟和生殖器肿物。我们报告一例42岁女性患者，其左肾上极有假性肿瘤样肿物，最终诊断为异位脾。本文简要回顾了其病因、诊断及治疗方面的文献。我们强调在鉴别诊断左肾、肾上腺及腹膜后肿物时应考虑到异位脾组织。我们建议进行CT和MRI等影像学检查，必要时辅以肝脏/脾脏放射性核素扫描。对于确诊的无症状盆腔外异位脾的特定病例，我们主张采取非激进的态度，对于有症状的病例或继发性门静脉高压病例则推迟脾切除术。
