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成年患者腹腔镜脾切除术治疗脾淋巴管瘤:1例罕见病例报告

Splenic lymphangioma in adult patient treated with laparoscopic splenectomy: A rare case report.

作者信息

Pham Minh Duc, Nguyen Minh Thao, Vo Minh Tri Thi, Hoang Van Trung, Pham Ngoc Trinh Thi

机构信息

Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.

Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue, Vietnam.

出版信息

SAGE Open Med Case Rep. 2023 Jan 3;11:2050313X221147196. doi: 10.1177/2050313X221147196. eCollection 2023.

Abstract

Splenic lymphangioma is a benign cystic tumor that develops as a result of lymphatic vessels' congenital abnormalities. It is a rare condition that mostly occurs in children and young adults. Due to the lack of typical symptoms and signs, splenic lymphangioma is difficult to diagnose and often incidentally revealed during radiological examinations. We report a case of a 55-year-old Asian female, who presented with left upper quadrant abdominal pain in the past 3 days. She had mild upper abdominal tenderness, with no other specific findings. Abdominal contrast material-enhanced computed tomography revealed three hypodense lesions arising from a normal-sized spleen. The histologic findings after laparoscopic splenectomy demonstrated a 3-cm-diameter yellowish-white tumor made up of multiple cystic structures. Primary benign splenic tumors are exceedingly rare, especially in adults over 20. While small lesions are mostly asymptomatic, bigger lesions can cause organ compression or even rupture. Therefore, even in adults with pain in the left upper quadrant abdomen or enlarged spleen, splenic lymphangioma should be taken into account in the differential diagnosis. The case serves as an example of a rare congenital splenic tumor. Treatment of this benign splenic abnormality with laparoscopic splenectomy is a good, safe approach.

摘要

脾淋巴管瘤是一种良性囊性肿瘤,由淋巴管的先天性异常发展而来。它是一种罕见疾病,主要发生于儿童和青年。由于缺乏典型症状和体征,脾淋巴管瘤难以诊断,常在影像学检查时偶然发现。我们报告一例55岁亚洲女性病例,她在过去3天出现左上腹疼痛。她有轻度上腹部压痛,无其他特异性发现。腹部对比增强计算机断层扫描显示,正常大小的脾脏出现三个低密度病变。腹腔镜脾切除术后的组织学检查结果显示,一个直径3厘米的黄白色肿瘤,由多个囊性结构组成。原发性良性脾肿瘤极为罕见,尤其是在20岁以上的成年人中。虽然小病变大多无症状,但较大病变可导致器官压迫甚至破裂。因此,即使是左上腹疼痛或脾脏肿大的成年人,在鉴别诊断时也应考虑脾淋巴管瘤。该病例是罕见的先天性脾肿瘤的一个例子。采用腹腔镜脾切除术治疗这种良性脾异常是一种良好、安全的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48af/9829880/dd7d356cea38/10.1177_2050313X221147196-fig1.jpg

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