Department of General Surgery, Notre Dame des Secours University Hospital Center, Jbeil, Mont-Liban, Lebanon
Holy Spirit University of Kaslik Faculty of Medicine and Medical Sciences, Jounieh, Lebanon.
BMJ Case Rep. 2020 Oct 7;13(10):e236255. doi: 10.1136/bcr-2020-236255.
A 60-year-old woman was investigated for abdominal pain and increasing asthenia. Abdominal CT revealed a 25 mm hypodense cystic lesion in the tail of the pancreas. MRI showed a multiloculated cystic lesion, T1-hypointense and T2-hyperintense lesion, without wall enhancement. Endoscopic ultrasound detected a 25 mm multi-loculated cystic lesion, with regular margin and without pancreatic duct communication. Diagnosis of pancreatic mucinous cystadenoma was discussed and the patient was referred to surgery. She underwent distal pancreatectomy with spleen preservation. Pathological examination revealed the diagnosis of pancreatic mesothelial cyst. Histologically, the cyst was multiloculated, lined by cuboidal epithelium, ovoid nuclei and amphophilic cytoplasm, without mucin deposition or cytological atypia. Immunohistochemistry examination revealed positive staining for cytokeratin 5/6, vimentin and calretinin. At 1-year follow-up, she is in her usual health, without any symptoms.
一位 60 岁女性因腹痛和乏力进行就诊。腹部 CT 显示胰腺尾部有一个 25mm 的低密囊性病灶。MRI 显示一个多房囊性病变，T1 低信号，T2 高信号，无壁强化。内镜超声检查发现一个 25mm 的多房囊性病变，边界规则，与胰管无交通。讨论后考虑胰腺黏液性囊腺瘤的诊断，并将患者转至外科。行保留脾脏的胰体尾切除术。病理检查提示胰腺间皮囊肿。组织学上，囊肿多房，被覆立方上皮，卵圆形细胞核和嗜酸性细胞质，无黏液沉积或细胞学异型性。免疫组化检查显示细胞角蛋白 5/6、波形蛋白和钙视网膜蛋白阳性。1 年随访时，患者一般情况良好，无症状。
