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胰腺囊性淋巴管瘤:1例罕见病例报告及文献复习

Cystic lymphangioma of pancreas: A rare case report and review of the literature.

作者信息

Chen Diyu, Feng Xiaode, Lv Zhen, Xu Xiaofeng, Ding Chaofeng, Wu Jian

机构信息

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health Collaborative Innovation Center for Diagnosis Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2018 Jul;97(28):e11238. doi: 10.1097/MD.0000000000011238.

Abstract

RATIONALE

Lymphangiomas are benign lymphatic malformations that mostly occur in the neck and axillary regions. Abdominal lymphangioma is a rare type of this tumor, and pancreatic lymphangioma accounts for less than 1% of all lymphangiomas. In this report, we firstly reveal the application of ultrasound-guided puncture drainage combined with cell morphological examination for the diagnosis of pancreatic lymphangioma.

PATIENT CONCERNS

A 35-year-old male patient was admitted to our hospital with recurrent abdominal pain and general weakness for 1 week. From abdominal ultrasound (US) showed that a large cystic lesion occupied the abdomen, about 30.0cm×25.0cm, leading to suspicion of lymphatic cyst. Computed tomography (CT) was performed for further diagnosis and staging.

DIAGNOSES

According to pathological findings in combination with immunohistochemical features, pancreatic lymphangioma was made.

INTERVENTIONS

To relieve symptoms of discomfort in the patient, distal pancreatectomy and splenectomy was carried out 1 week after the CT scan.

OUTCOMES

The patient recovered to normal status within 19 days after surgery.

LESSONS

The abdominal cystic lymphangiomas are difficult to be differential diagnosed from other cystic lesions. And the origin of the tumor is also hard to be detected before operation. We should combine image and pathological examination to clarify a diagnosis. Although lymphangiomas are benign tumours, they can encroach on adjacent organs and grow to an enormous size and that, resection of these invaded organs may be required for a complete excision.

摘要

原理

淋巴管瘤是良性淋巴管畸形,大多发生于颈部和腋窝区域。腹部淋巴管瘤是该肿瘤的一种罕见类型,胰腺淋巴管瘤占所有淋巴管瘤的比例不到1%。在本报告中,我们首次揭示了超声引导下穿刺引流联合细胞形态学检查在胰腺淋巴管瘤诊断中的应用。

患者情况

一名35岁男性患者因反复腹痛和全身乏力1周入院。腹部超声显示一个大的囊性病变占据腹部,大小约为30.0cm×25.0cm,怀疑为淋巴管囊肿。进行了计算机断层扫描(CT)以进一步诊断和分期。

诊断

根据病理结果结合免疫组化特征,诊断为胰腺淋巴管瘤。

干预措施

为缓解患者的不适症状,在CT扫描1周后进行了胰体尾切除术和脾切除术。

结果

患者术后19天恢复至正常状态。

经验教训

腹部囊性淋巴管瘤难以与其他囊性病变进行鉴别诊断。术前也很难检测到肿瘤的起源。我们应结合影像学和病理检查以明确诊断。尽管淋巴管瘤是良性肿瘤,但它们可侵犯相邻器官并长得很大,可能需要切除这些受侵犯的器官才能完全切除。

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