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老年男性脾脏未消散“脓肿”——脾脏淋巴瘤的一种不常见表现。

A non-resolving splenic 'abscess' in an elderly male - An unusual manifestation of splenic lymphoma.

机构信息

Associate Professor, Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Junior Resident, Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Trop Doct. 2021 Apr;51(2):251-252. doi: 10.1177/0049475520981305. Epub 2020 Dec 25.

Abstract

Splenic abscess is a relatively uncommon condition, posing a diagnostic and therapeutic challenge for the treating physician. It occurs due to haematogenous spread from endocarditis or other septic foci, especially in immune-compromised individuals and diabetics. We describe an elderly male who presented with splenomegaly and low-grade fever with no predisposing factors. Examination revealed a tender splenomegaly. Ultrasonography (US) showed a hypoechoic area within the spleen from which guided aspiration of pus grew and . Percutaneous drainage and culture-based antibiotics failed to resolve the abscess, obligating surgical drainage. Intraoperative biopsy from the abscess wall was reported as splenic marginal lymphoma. This unusual presentation of lymphoma needs to be considered in splenic abscess without known risk factors.

摘要

脾脓肿是一种相对少见的疾病,对治疗医生的诊断和治疗提出了挑战。它是由于心内膜炎或其他感染灶的血行播散引起的,特别是在免疫功能低下者和糖尿病患者中。我们描述了一位老年男性,他表现为脾肿大和低热,没有诱发因素。检查发现脾肿大伴有触痛。超声检查显示脾脏内有低回声区,引导抽吸脓液,培养出 和 。经皮引流和基于培养的抗生素治疗未能使脓肿消退,因此需要手术引流。脓肿壁的术中活检报告为脾边缘区淋巴瘤。在没有明确危险因素的脾脓肿中,需要考虑这种非典型的淋巴瘤表现。

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