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伪装成胃间质瘤的脾组织植入:一例报告。

Splenosis masquerading as gastric stromal tumor: A case report.

作者信息

Zheng Hui-Da, Xu Jian-Hua, Sun Ya-Feng

机构信息

Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.

出版信息

World J Clin Cases. 2021 Jul 16;9(20):5724-5729. doi: 10.12998/wjcc.v9.i20.5724.

Abstract

BACKGROUND

Splenosis is a rare benign disease that often disguises itself as a malignant tumor. There are few articles providing a comprehensive description of splenosis, especially cases located in the stomach being treated by laparoscopic surgery.

CASE SUMMARY

A 44-year-old man presented with recurrent upper abdominal pain for more than half a year. The patient had splenic rupture caused by trauma more than 10 years ago and underwent splenectomy. An abdominal contrast-enhanced computed tomography scan revealed an irregular soft tissue density. Gastroscopy revealed an approximately 3.0 cm × 3.0 cm mucosal eminence at the posterior wall of the upper segment of the gastric body. Biopsy was not performed since the lesion was found under the mucosa and the gastric mucosa appeared normal. According to these findings, a diagnosis of gastric stromal tumor was made, although a definitive differential diagnosis was not known before surgery. When laparoscopic resection of the gastric stromal tumor was performed, an astonishing finding was made when postoperative pathology showed that the lesion comprised typical spleen tissue.

CONCLUSION

This case highlights the strong similarities between splenosis and malignant tumors. A detailed medical history combined with various effective auxiliary examinations can help improve differential diagnosis.

摘要

背景

脾组织植入是一种罕见的良性疾病,常伪装成恶性肿瘤。很少有文章对脾组织植入进行全面描述,尤其是腹腔镜手术治疗位于胃部的病例。

病例摘要

一名44岁男性,反复上腹部疼痛半年余。该患者10多年前因外伤导致脾破裂并接受了脾切除术。腹部增强CT扫描显示不规则软组织密度影。胃镜检查发现胃体上段后壁有一约3.0 cm×3.0 cm黏膜隆起。由于病变位于黏膜下且胃黏膜外观正常,未进行活检。根据这些发现,诊断为胃间质瘤,尽管术前尚未明确鉴别诊断。在进行腹腔镜下胃间质瘤切除手术时,术后病理显示病变为典型的脾脏组织,这一惊人发现令人意外。

结论

该病例突出了脾组织植入与恶性肿瘤之间的高度相似性。详细的病史结合各种有效的辅助检查有助于提高鉴别诊断水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9cc/8281394/19d1846b0963/WJCC-9-5724-g001.jpg

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