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慢性乙型肝炎患者肝内脾组织植入酷似肝细胞癌:一例报告及文献复习

Intrahepatic splenosis mimics hepatocellular carcinoma in a patient with chronic hepatitis B: A case report and literature review.

作者信息

Wang Wen-Chao, Li Xi-Feng, Yan Zhen-Lin, Wang Yu, Ma Jun-Yong, Shi Le-Hua, Zhang Xiao-Feng

机构信息

Department of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(47):e8680. doi: 10.1097/MD.0000000000008680.

Abstract

BACKGROUND

Splenosis is a benign and relatively uncommon condition caused by trauma or splenectomy or other procedures involving splenic tissue. It is usually asymptomatic, and often diagnosed accidentally, especially misdiagnosed as malignant tumor.

METHODS

A 54-year-old man with prior history of chronic hepatitis B virus infection and underwent splenectomy for traumatic splenic rupture following a traffic accident 23 years previously was admitted to our hospital and found a hepatic mass in the right upper quadrant during an imaging examination. The diagnosis of his was not clear and finally he agreed to receive a surgical treatment.

RESULTS

During the operation, we found a mass in the right posterior lobe of the liver and a hard nodule on the right side of the diaphragm, both were completely resected, and postoperative histopathologic examination revealed that all excised tissues were proved to have histological structure typical for the spleen.

CONCLUSIONS

The occurrence of intrahepatic splenosis is rare with only few cases previously reported in the literature. It is a benign disease and sometimes difficult to distinguish from diseases of the liver. The need for positive surgical resection of splenosis is still controversial.

摘要

背景

脾组织异位是一种由创伤、脾切除术或其他涉及脾组织的手术引起的良性且相对罕见的病症。它通常无症状,常被意外诊断,尤其是被误诊为恶性肿瘤。

方法

一名54岁男性,有慢性乙型肝炎病毒感染史,23年前因交通事故导致外伤性脾破裂而行脾切除术,入住我院,在影像学检查中发现右上腹有一肝脏肿块。其诊断不明确,最终他同意接受手术治疗。

结果

手术中,我们在肝右后叶发现一个肿块,在膈肌右侧发现一个硬结节,两者均被完整切除,术后组织病理学检查显示所有切除组织均具有典型的脾脏组织结构。

结论

肝内脾组织异位的发生罕见,此前文献中仅有少数病例报道。它是一种良性疾病,有时难以与肝脏疾病区分。对于脾组织异位进行积极手术切除的必要性仍存在争议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f66f/5708946/f5428e797468/medi-96-e8680-g002.jpg

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