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脾脏表皮样囊肿,病例报告。

Epidermoid cyst of the spleen, a case report.

作者信息

Vuyyuru Sharmilee, Kharbutli Bilal

机构信息

Department of General Surgery, Henry Ford Wyandotte Hospital, Wyandotte MI, USA.

Department of General Surgery, Henry Ford Wyandotte Hospital, Wyandotte MI, USA.

出版信息

Int J Surg Case Rep. 2017;35:57-59. doi: 10.1016/j.ijscr.2017.04.014. Epub 2017 Apr 18.

Abstract

INTRODUCTION

Splenic tumors are rare and are either primary or secondary, benign or malignant. Most have none to minimal symptomatology and are found incidentally. Splenic cysts can be infectious, congenital, or traumatic. Epidermoid cysts and parasitic cysts are examples of primary cysts and usually have a classic presentation on imaging. Despite advanced imaging modalities and patient's clinical presentation, it can be difficult to diagnose an epidermoid cyst without histological examination. The purpose of this paper is to discuss typical findings of primary splenic cysts on imaging, but how they may differ in appearance.

PRESENTATION OF CASE

51 year old female who presented with vague abdominal discomfort and was found to have a large splenic mass with cystic components on imaging which did not demonstrate a typical primary splenic cyst appearance. Patient underwent an uneventful hand-assisted laparoscopic total splenectomy and had an uneventful recovery with histopathology revealing an epidermoid splenic cyst.

CONCLUSION

Primary splenic cysts are difficult to diagnose and differentiate with imaging alone. They have a variable presentation and can present like as a cystic mass. It is important to include them in the differential diagnosis of splenic masses since histopathology is the final determinant of the diagnosis.

摘要

引言

脾脏肿瘤较为罕见,分为原发性和继发性,良性或恶性。大多数患者无明显症状或仅有轻微症状,多为偶然发现。脾囊肿可分为感染性、先天性或外伤性。表皮样囊肿和寄生虫性囊肿是原发性囊肿的例子,通常在影像学上有典型表现。尽管有先进的影像学检查方法和患者的临床表现,但未经组织学检查很难诊断表皮样囊肿。本文旨在讨论原发性脾囊肿在影像学上的典型表现,以及它们在外观上可能存在的差异。

病例介绍

一名51岁女性,因腹部隐痛就诊,影像学检查发现脾脏有一个较大的肿块,伴有囊性成分,但其表现并不典型。患者接受了顺利的手辅助腹腔镜全脾切除术,术后恢复良好,组织病理学检查显示为表皮样脾囊肿。

结论

原发性脾囊肿仅靠影像学检查很难诊断和鉴别。它们的表现多样,可表现为囊性肿块。鉴于组织病理学是诊断的最终决定因素,因此将其纳入脾肿块的鉴别诊断很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4489/5406525/1d3af10e7dba/gr1.jpg

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