Ehricht A, Pützschler F, Weissmann K, Klenske M
Klinikum Chemnitz gGmbH, Krankenhaus Küchwald, Klinik für Thoraxchirurgie, Chemnitz.
Zentralbl Chir. 2009 Apr;134(2):178-81. doi: 10.1055/s-2008-1076882. Epub 2009 Apr 20.
We describe the case of a patient aged 25 years showing the rare finding of a mediastinal tumour containing ectopic pancreatic -tissue (maximum diameter of 15 cm). At admission, the patient presented with symptoms comparable to those of pneumonia. A computed tomographic scan of the thorax confirmed an -extensive mediastinal mass. A transthoracic puncture aspiration followed by a cytological examination failed to provide information of diagnostical relevance. OPERATION: To resect the mass and its adjacent tissue completely, a posterolateral thoracotomy on the left side was performed. The histopathological examination revealed exo- and endocrinic pancreatic tissue and a pancreatic pseudocyst with-out a thoracopancreatic fistula.
The incidence of mediastinal cysts containing pancreatic tissue seems to be extremely low. Above all, our case is the only one presenting clinical symptoms of a lobar pneumonia. In consideration of the current literature, we give a description of histological pattern, the possible pathogenesis and classification.
Surgical therapy provides the chance for tumour removal. It provides an excellent outcome when performed completely.
我们描述了一名25岁患者的病例,该患者出现罕见的纵隔肿瘤,其中含有异位胰腺组织(最大直径为15厘米)。入院时,患者表现出与肺炎相似的症状。胸部计算机断层扫描证实存在广泛的纵隔肿块。经胸穿刺抽吸并进行细胞学检查未能提供具有诊断意义的信息。手术:为了完全切除肿块及其相邻组织,在左侧进行了后外侧开胸手术。组织病理学检查显示有外分泌和内分泌胰腺组织以及一个胰腺假性囊肿,无胸胰瘘。
含有胰腺组织的纵隔囊肿的发病率似乎极低。最重要的是,我们的病例是唯一表现出大叶性肺炎临床症状的病例。考虑到当前的文献,我们对组织学模式、可能的发病机制和分类进行了描述。
手术治疗为切除肿瘤提供了机会。如果完全切除,效果极佳。