Nagamatsu Hideyasu, Takahashi Ken, Ueo Tetsuya, Narita Ryouichi, Mukai Tamotsu, Ishida Tetsuya, Fukuzawa Kengo, Wakasugi Kenzou, Takagi Hajime, Yonemasu Hirotoshi, Seike Masataka, Koba Ikurou
Department of Gastroenterology, Oita Red Cross Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2011 Aug;108(8):1420-7.
A 46-year-old man was admitted to our hospital for further evaluation of a hypoechogenic mass in the pancreatic body. He had no history of hypertension, pancreatitis, abdominal trauma, or portal hypertension. He had no abdominal symptoms. A contrast-enhanced CT scan demonstrated a hypodense, round shaped mass. EUS and MRI also showed it to be a pancreatic mass. Because of the tumor size of more than 30mm and the possibility of malignancy, distal pancreatectomy was performed. Microscopic findings showed the mass was the dissection of the proximal splenic artery. The true lumen of the dissecting aneurysm was occluded and the false lumen developed fusiform dilatation. Moreover, microscopic findings revealed the rupture of the false lumen complicated by pseudoaneurysm. We finally diagnosed the lesion simulating a pancreatic tumor as the pseudoaneurysm of the splenic artery.
一名46岁男性因胰体部低回声肿块入院进一步评估。他无高血压、胰腺炎、腹部外伤或门静脉高压病史。他无腹部症状。增强CT扫描显示一个低密度圆形肿块。超声内镜和磁共振成像也显示其为胰腺肿块。由于肿瘤大小超过30mm且有恶性可能,遂行胰体尾切除术。显微镜检查结果显示肿块为脾动脉近端夹层。夹层动脉瘤的真腔闭塞,假腔呈梭形扩张。此外,显微镜检查发现假腔破裂并伴有假性动脉瘤形成。我们最终将这个模拟胰腺肿瘤的病变诊断为脾动脉假性动脉瘤。