Veal David R, Hammil Chet W, Wong Linda L
Department of Surgery, Hawai'i Medical Center East and University of Hawai'i, John A. Burns School of Medicine, Honolulu 96813, USA.
Hawaii Med J. 2010 Feb;69(2):32-4.
Tumors presenting in the inguinal hernia sac are considered to be extremely rare, with the more common neoplasms metastasizing from the gastrointestinal tract, ovary and prostate. We report the case of Mantle cell lymphoma identified in the inguinal hernia sac following hernia repair While the hernia sac appeared normal to the surgeon, evaluation by the pathologist showed subtle gross irregularities, with subsequent histologic and immunochemical diagnosis of Mantle cell lymphoma. Twelve previous cases of a lymphoma diagnosed during hernia repair have been described in the English literature. This is the first report of Mantle cell lymphoma found in the hernia sac. This case illustrates the value of routine microscopic evaluation of hernia sacs found from inguinal/femoral herniorrhaphies, as it may be the primary presentation of an asymptomatic metastatic lymphoma. Additionally it underscores the importance of the surgeon's role in screening hernia sacs if the practice of submitting only macroscopically abnormal specimens for microscopic evaluation is adopted.
腹股沟疝囊中出现肿瘤被认为极为罕见，更常见的是胃肠道、卵巢和前列腺转移而来的肿瘤。我们报告一例在疝修补术后腹股沟疝囊中发现套细胞淋巴瘤的病例。虽然外科医生检查时疝囊外观正常，但病理学家评估发现有细微的大体不规则之处，随后经组织学和免疫化学诊断为套细胞淋巴瘤。英文文献中已描述过12例在疝修补术中诊断出淋巴瘤的病例。这是首次报告在疝囊中发现套细胞淋巴瘤。该病例说明了对腹股沟/股疝修补术中发现的疝囊进行常规显微镜评估的价值，因为这可能是无症状转移性淋巴瘤的主要表现形式。此外，它强调了如果仅将肉眼异常的标本送检进行显微镜评估，外科医生在筛查疝囊方面的重要作用。
