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一名3岁女童乙状结肠系膜囊肿病例。

A case of a mesenteric cyst in the sigmoid colon of a 3-year-old girl.

作者信息

Iida Shinya, Furukawa Kiyonori, Terada Yoshie, Sugisaki Yuichi, Yoshimura Kazuyasu, Tajiri Takashi

机构信息

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School.

出版信息

J Nippon Med Sch. 2009 Oct;76(5):247-52. doi: 10.1272/jnms.76.247.

Abstract

Mesenteric cysts are rare. In this paper we present a case of a mesenteric cyst in the sigmoid colon of a 3-year-old girl. On the first visit to our department, a smooth-surfaced soft mass approximately 15 cm in diameter was noticed in the right lower abdomen. Although the patient complained of lower abdominal pain, there was no tenderness or guarding. Laboratory tests indicated no abnormality except a slightly increased level of C-reactive protein (2.3 mg/dL). A plain abdominal X-ray film revealed displacement of colonic gas from the right lower abdomen, and abdominal ultrasonography and computed tomography revealed a smooth cystic mass measuring 9.5 x 8.7 x 4.7 cm that contained many internal septa. Because the patient had several symptoms, we performed a surgical operation under general anesthesia. We found a light-red cystic mass, 8.5 x 8.0 x 3.0 cm in size, in the mesentery of the sigmoid colon and surrounding the sigmoid colon, without adhesion to any other organ. We approached the cystic mass from the sigmoid colon and the mesentery of sigmoid colon and completely resected it without complications. The content of the cystic mass was a pale-yellow serous fluid. A cytological examination revealed mainly lymphocytes with reactive mesothelial cells. The resulting pathological diagnosis was a multi-lobular mesenteric cyst. Immunohistochemical staining with D2-40 antibody was positive value along the wall of the cyst, indicating that the cyst was derived from a lymphatic vessel.

摘要

肠系膜囊肿较为罕见。在本文中,我们报告了一例3岁女童乙状结肠系膜囊肿的病例。首次来我院就诊时,在右下腹发现一个直径约15厘米、表面光滑的柔软肿块。尽管患者主诉下腹部疼痛,但无压痛或肌紧张。实验室检查除C反应蛋白水平略有升高(2.3毫克/分升)外无异常。腹部X线平片显示结肠气体从右下腹移位,腹部超声和计算机断层扫描显示一个大小为9.5×8.7×4.7厘米的光滑囊性肿块,内有许多分隔。由于患者有多种症状,我们在全身麻醉下进行了手术。我们在乙状结肠系膜中发现一个大小为8.5×8.0×3.0厘米的淡红色囊性肿块,围绕着乙状结肠,与其他任何器官均无粘连。我们从乙状结肠和乙状结肠系膜处接近囊性肿块并将其完整切除,无并发症发生。囊性肿块的内容物为淡黄色浆液性液体。细胞学检查显示主要为淋巴细胞和反应性间皮细胞。最终病理诊断为多房性肠系膜囊肿。用D2-40抗体进行免疫组化染色,囊肿壁呈阳性,表明囊肿起源于淋巴管。

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