Meyer T, Maier M, Höller S, Fein M
Chirurgische Universitätsklinik und Poliklinik, Würzburg.
Zentralbl Chir. 2007 Feb;132(1):73-6. doi: 10.1055/s-2007-960480.
According to autoptic studies, accessory spleens may be found in 10-15% of the population and most of them are usually located at or near the splenic hilum. Only in 1-2% they are located in the pancreatic tail. We report a rare case of intrapancreatic accessory spleen which radiologically mimicked a tumor in the tail of the pancreas.
A 54-year-old man was diagnosed with a tumor at the pancreatic tail. In the preoperative computed tomography (CT), there was a lesion (2.6 cm in diameter) in the pancreatic tail and two locoregional lesions (1 and 1.5 cm in diameter), which had intensive contrast enhancement. The diagnosis of a nonfunctioning endocrine pancreatic tail carcinoma with lymph node metastasis was made.
Intraoperative examination showed two accessory spleens nearby the pancreatic tail. As pancreatic cancer could not be excluded because of the local findings, an oncological left pancreatectomy was performed. Histological examination excluded cancer and revealed an intrapancreatic accessory spleen and two accessory spleens nearby the pancreatic tail.
Intrapancreatic accessory spleen should be included in the differential diagnosis of pancreatic neoplasm.
根据尸检研究，10% - 15%的人群中可发现副脾，其中大多数通常位于脾门或其附近。仅1% - 2%位于胰尾。我们报告一例罕见的胰腺内副脾病例，其在影像学上酷似胰尾肿瘤。
一名54岁男性被诊断为胰尾肿瘤。术前计算机断层扫描（CT）显示，胰尾有一个病变（直径2.6厘米）以及两个局部病变（直径分别为1厘米和1.5厘米），这些病变有明显的强化。诊断为无功能性内分泌性胰尾癌伴淋巴结转移。
术中检查发现胰尾附近有两个副脾。由于局部表现不能排除胰腺癌，遂行肿瘤学上的左胰切除术。组织学检查排除了癌症，发现是胰腺内副脾以及胰尾附近的两个副脾。
胰腺内副脾应纳入胰腺肿瘤的鉴别诊断。
