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肿瘤学中的陷阱:一例独特的胸腔脾组织植入病例,酷似一名接受过乳腺癌切除术患者的恶性肿瘤。

Pitfalls in oncology: a unique case of thoracic splenosis mimicking malignancy in a patient with resected breast cancer.

作者信息

Gelsomino Francesco, Castellani Maria Rita, Marchianò Alfonso, Duca Matteo, Mariani Paola, Aliberti Gianluca, Maccauro Marco, Duranti Leonardo, Capri Giuseppe, de Braud Filippo Guglielmo, Bianchi Giulia Valeria

机构信息

1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.

出版信息

J Thorac Dis. 2016 Jun;8(6):E403-7. doi: 10.21037/jtd.2016.04.54.

Abstract

Thoracic splenosis (TS) is a condition of autotransplantation of splenic tissue into the pleural cavity after thoraco-abdominal trauma, with diaphragmatic and spleen injury. It is usually asymptomatic and discovered as an incidental finding at imaging performed for other reasons. Its differential diagnosis regards different benign and malignant conditions and should be discerned avoiding invasive procedures. We report a case of thoracic mass associated with pleural nodules mimicking malignancy in a patient with resected breast cancer for whom a diagnosis of TS was made early by using non-invasive methods. Briefly, we review the literature data on TS, comment concisely the possible implications of using invasive procedures and describe the current non-invasive techniques available. Furthermore, we highlight the importance of an accurate medical history collection, the role of the multidisciplinary board and their impact on treatment decision making. Finally, we conclude that clinical information and imaging would be the discriminating factors to avoid unnecessary invasive procedures.

摘要

胸内脾种植(TS)是一种在胸腹外伤后,伴有膈肌和脾脏损伤,脾组织自体移植至胸腔的病症。它通常无症状,多在因其他原因进行影像学检查时偶然发现。其鉴别诊断涉及不同的良性和恶性病症,应避免采用侵入性操作进行辨别。我们报告了一例与胸膜结节相关的胸内肿块病例,该病例疑似恶性肿瘤,患者曾接受乳腺癌切除术,通过非侵入性方法早期诊断为TS。简要来说,我们回顾了关于TS的文献资料,简要评论了采用侵入性操作可能带来的影响,并描述了当前可用的非侵入性技术。此外,我们强调了准确收集病史的重要性、多学科团队的作用及其对治疗决策的影响。最后,我们得出结论,临床信息和影像学检查将是避免不必要侵入性操作的鉴别因素。

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