Luncă S, Bouraş G, Dumitru L
Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină.
Rev Med Chir Soc Med Nat Iasi. 2005 Jul-Sep;109(3):548-55.
Splenic cysts of all types are a relatively rare entity. The origin of epithelial cysts of the spleen is controversial, most probably congenital in origin. Generally, epithelial cysts of the spleen are asymptomatic and discovered incidentally. We present the case of a 40-year-old woman with a 3.5 cm splenic cyst diagnosed four years before. The cyst raised progressively in dimension, the actual size being of 6.5 cm. Computed tomography scan and magnetic resonance showed a central splenic cyst in close relations with main splenic vessels. An initial indication of partial splenectomy was established, eventually a total splenectomy being performed by laparoscopy due to close relations of the cyst with the main hilar splenic vessels. The hemostasis was assured with the aid of Ligasure Atlas 10 mm instrument. The pathology examination revealed a multilocular splenic cyst with a cuboidal epithelial lining. Central localization of splenic cysts represents an indication for total splenectomy. Laparoscopy provides a minimal access method of obtaining pathological confirmation of diagnosis, reduction of cyst complications, and a short hospital stay. This article discusses different aspects of epithelial cysts related to pathology, diagnostic and indications for operative treatment, a review of the literature being also presented.
所有类型的脾囊肿都是相对罕见的病症。脾脏上皮囊肿的起源存在争议,很可能是先天性的。一般来说,脾脏上皮囊肿无症状,多为偶然发现。我们报告一例40岁女性患者,其脾脏囊肿在4年前被诊断出,大小为3.5厘米。囊肿尺寸逐渐增大,实际大小为6.5厘米。计算机断层扫描和磁共振成像显示脾脏中央有一个囊肿,与脾主要血管关系密切。最初确定的治疗方案是部分脾切除术,最终由于囊肿与脾门主要血管关系密切,通过腹腔镜进行了全脾切除术。借助10毫米的Ligasure Atlas器械确保了止血。病理检查显示为一个具有立方上皮内衬的多房性脾囊肿。脾脏囊肿的中央定位是全脾切除术的指征。腹腔镜检查提供了一种微创方法,可用于获得诊断的病理确认、减少囊肿并发症并缩短住院时间。本文讨论了上皮囊肿在病理学、诊断及手术治疗指征等方面的不同情况,并对相关文献进行了综述。