Department of Gastroenterology, Suzuka Kaisei Hospital, Suzuka, Mie, Japan.
Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Clin J Gastroenterol. 2020 Dec;13(6):1360-1366. doi: 10.1007/s12328-020-01228-y. Epub 2020 Sep 9.
A 45-year-old woman presented with upper abdominal and back pain. A cystic lesion in the pancreas and inflammation around the splenic artery were detected by computed tomography. Although imaging studies were difficult to exclude malignancy, pathological and cytological findings of a fine-needle aspiration showed no signs of malignancy. The patient was, therefore, followed-up for 3 months, during which time the cyst increased in size and developed a cyst-in-cyst structure. She was diagnosed with mucinous cyst neoplasm and underwent distal pancreatectomy. Histologically, the patient was diagnosed as low-grade mucinous cystic adenoma. Soft tissue shadows around the splenic artery were considered to indicate fibrosis and infiltration of inflammatory cells. After distal pancreatectomy, the patient has been uneventful with symptom resolution. This case highlights the potentially atypical presentation of mucinous cystic neoplasms with inflammatory cell infiltration around the splenic artery.
一位 45 岁女性因上腹痛和背痛就诊。计算机断层扫描发现胰腺内囊性病变和脾动脉周围炎症。尽管影像学检查难以排除恶性肿瘤，但细针抽吸的病理和细胞学检查均未见恶性肿瘤迹象。因此，患者接受了 3 个月的随访，在此期间，囊肿增大并形成囊内囊结构。患者被诊断为黏液性囊腺瘤，并接受了胰体尾切除术。组织学上，患者被诊断为低级别黏液性囊性腺瘤。脾动脉周围的软组织影提示纤维化和炎症细胞浸润。胰体尾切除术后，患者无症状，病情缓解。本病例提示脾动脉周围有炎症细胞浸润的黏液性囊腺瘤可能表现不典型。
