Bürrig K F
Department of Biophysics and Pathology, University of Düsseldorf, F.R.G.
Am J Surg Pathol. 1988 Apr;12(4):275-81.
Nonparasitic cysts of the spleen are classified as primary or epithelial cysts if their inner surface has a cellular lining. Depending upon the pattern of the inner surface cell layer, the primary splenic cysts are divided into mesothelial or epidermoid subtypes. In order to study their pathogenesis, five epithelial splenic cysts (two with mesothelial lining, and three with foci of stratified squamous epithelium) were investigated by scanning and transmission electron microscopy and by immunohistochemistry. In places, the squamous epithelium was continuous with a flattened mesothelial layer. Furthermore, within the stratified epithelium, a continuous spectrum of cytodifferentiation from mesothelial to squamous cells was found. Thus, the epidermoid splenic cyst seems to be a variant of the mesothelial cyst with focal squamous metaplasia. Rupture of the splenic capsule with hemosiderin deposits and infoliation of the mesothelium was seen in one case, implying a traumatic genesis. In addition, stoma-like channels providing connections between the lumen of the cyst and the sinus of the adjacent splenic tissue were detected by scanning electron microscopy. As with other cystic lesions, the influx of blood cells and proteinaceous fluid from these stomata may contribute to the growth of the cysts, which are usually of considerable size when surgically removed.
脾脏的非寄生虫性囊肿如果其内表面有细胞内衬，则分类为原发性或上皮性囊肿。根据内表面细胞层的模式，原发性脾囊肿可分为间皮或表皮样亚型。为了研究其发病机制，通过扫描电子显微镜、透射电子显微镜和免疫组织化学对5个上皮性脾囊肿（2个有间皮内衬，3个有复层鳞状上皮灶）进行了研究。在某些部位，鳞状上皮与扁平的间皮层相连。此外，在复层上皮内，发现了从间皮细胞到鳞状细胞的连续细胞分化谱。因此，表皮样脾囊肿似乎是间皮囊肿伴有局灶性鳞状化生的一种变体。在1例中可见脾包膜破裂伴含铁血黄素沉积和间皮剥脱，提示有创伤性起源。此外，通过扫描电子显微镜检测到在囊肿腔与相邻脾组织血窦之间存在类似气孔样的通道。与其他囊性病变一样，血细胞和蛋白质液体从这些气孔流入可能有助于囊肿生长，手术切除时囊肿通常体积较大。
