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成人患者孤立性脾淋巴管瘤表现为巨大肿块致贫血和腹胀:一例报告

Isolated splenic lymphangioma presenting as a huge mass causing anemia and abdominal distension in an adult patient: a case report.

作者信息

Efared Boubacar, Atsame-Ebang Gabrielle, Zabeirou Aliou, Hammas Nawal, Mazaz Khalid, El Fatemi Hinde, Chbani Laila

机构信息

Department of Pathology, Hassan II University Hospital, Fez, Morocco.

Department of General and Visceral Surgery, Hassan II University Hospital, Fez, Morocco.

出版信息

J Med Case Rep. 2018 Apr 16;12(1):97. doi: 10.1186/s13256-018-1664-5.

Abstract

BACKGROUND

Lymphangiomas are uncommon benign lesions of lymphatic vessels very rarely affecting the spleen. Isolated involvement of the spleen in adult patients is rarely reported.

CASE PRESENTATION

We report a case of a 40-year-old Arabic woman who presented with a 25-cm abdominal mass, fatigue, and anemia evolving for 6 months. Her physical examination revealed anemic syndrome and an enormous splenomegaly extending beyond the umbilical area. An abdominal computed tomographic scan showed a 25-cm splenic mass with multiple hypodense nodules without enhancement after contrast injection. A surgical total splenectomy was performed. Histopathological analysis led to the diagnosis of cystic splenic lymphangioma. The patient's postoperative course was uneventful, and she was discharged from the hospital.

CONCLUSIONS

Isolated splenic lymphangioma in adult patients is very rare. The preoperative diagnosis is challenging because imaging techniques are not specific. Pathological analysis of the resected specimen is the only effective way to render the definitive diagnosis. Splenic lymphangiomas have a benign course after complete surgical resection.

摘要

背景

淋巴管瘤是淋巴管的罕见良性病变,极少累及脾脏。成人患者脾脏孤立受累的情况鲜有报道。

病例介绍

我们报告一例40岁阿拉伯女性病例,该患者出现一个25厘米的腹部肿块、疲劳和贫血症状,持续6个月。体格检查发现贫血综合征以及巨大脾肿大,脾肿大延伸至脐部以下区域。腹部计算机断层扫描显示一个25厘米的脾脏肿块,有多个低密度结节,注射造影剂后无强化。实施了手术全脾切除术。组织病理学分析确诊为囊性脾淋巴管瘤。患者术后恢复顺利,已出院。

结论

成人孤立性脾淋巴管瘤非常罕见。术前诊断具有挑战性,因为影像学技术不具有特异性。对切除标本进行病理分析是做出明确诊断的唯一有效方法。脾淋巴管瘤在完整手术切除后病程呈良性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6464/5901864/bc55d4fbfe31/13256_2018_1664_Fig1_HTML.jpg

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