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胸腔内和腹腔内脾组织融合。

Combined Intrathoracic and Abdominal Splenosis.

机构信息

Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Am J Case Rep. 2022 Nov 27;23:e937902. doi: 10.12659/AJCR.937902.

Abstract

BACKGROUND Splenosis refers to autotransplantation of splenic tissue after splenic injury or splenectomy, most frequently occurring in the abdominal and pelvic cavities. Thoracic splenosis is a rare condition associated with a history of simultaneous rupture of the spleen and diaphragm resulting from trauma. To the best of our knowledge, only a limited number of cases have been reported for combined intrathoracic and abdominal splenosis. CASE REPORT We present a case of a 50-year-old man with a history of splenectomy and left nephrectomy 15 years ago due to an accident, who had experienced chest pain for the past month. A 1-cm focal pleural thickening in the left posterior pleura was revealed on the chest computed tomography (CT) scan. We found this to be suspicious for a solitary fibrous tumor. Based on this information, surgery was performed for tumor removal, and the pathologic examination confirmed splenic tissues. The patient was then discharged without any complications. Further abdominopelvic CT showed several contrast-enhanced lesions, suggestive of intraperitoneal splenosis. CONCLUSIONS We would like to emphasize the importance of thorough history-taking to avoid misdiagnosis and unnecessary procedures with respect to the rarity of splenosis. Moreover, appropriate use of diagnostic tools, including radionuclide imaging studies, is recommended to establish an accurate diagnosis of thoracic splenosis.

摘要

背景

脾组织在脾损伤或脾切除后发生的自体移植称为脾种植,最常发生于腹腔和盆腔。胸内脾种植是一种罕见的病症,与同时发生的脾和横膈膜破裂有关,这种破裂通常由外伤引起。据我们所知,只有少数病例同时报告了胸内和腹腔脾种植。

病例报告

我们报告了 1 例 50 岁男性病例,该患者 15 年前因意外行脾切除术和左肾切除术,过去 1 个月有胸痛病史。胸部 CT 扫描显示左侧后胸膜有 1 厘米局灶性胸膜增厚,我们怀疑这是孤立性纤维瘤。根据这些信息,我们进行了手术切除肿瘤,病理检查证实为脾组织。患者随后无并发症出院。进一步的腹盆腔 CT 显示多个增强的病变,提示腹腔内脾种植。

结论

我们要强调仔细询问病史的重要性,以避免因脾种植罕见而误诊和不必要的操作。此外,建议适当使用放射性核素成像等诊断工具,以准确诊断胸内脾种植。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d332/9713598/90f99e0172fb/amjcaserep-23-e937902-g001.jpg

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