Li Ting
Department of Radiology, Yongkang First People's Hospital, Yongkang 321300, Zhejiang Province, China.
World J Clin Cases. 2023 Aug 16;11(23):5615-5621. doi: 10.12998/wjcc.v11.i23.5615.
Pancreatic cavernous hemangioma (pCH) is a rare type of benign vascular tumor. Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.
We describe a male patient, age 18, who presented with a pCH. Computed tomography, magnetic resonance imaging, and ultrasound showed cystic space in the tail of the pancreas. A dark spot sign on the T2 weighted image sequence was observed. Clinically, a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging, and the operative indication was clear. The patient underwent a distal pancreatic tumor resection under laparoscopic control. Immunohistochemical staining for CD31 and CD34 was positive; D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells; and calcium-binding protein was negative. The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage. No complications or recurrences were observed during the follow-up period.
Chronic spontaneous hemorrhage may occur in pCH, which may greatly influence the accuracy of diagnosis using imaging modalities. Surgical resection for uncertain pCH seems reasonable with a good outcome.
胰腺海绵状血管瘤（pCH）是一种罕见的良性血管肿瘤。由于临床怀疑度低且缺乏现有的横断面成像工具来将其与其他胰腺病变区分开来，做出正确诊断具有挑战性。
我们描述了一名18岁男性患者，其患有pCH。计算机断层扫描、磁共振成像和超声显示胰腺尾部有囊性间隙。在T2加权图像序列上观察到暗点征。临床上，术前结合影像学检查怀疑为伴有出血的黏液性囊性肿瘤，手术指征明确。患者在腹腔镜控制下接受了胰腺远端肿瘤切除术。CD31和CD34免疫组化染色呈阳性；D2-40在间质淋巴管中呈阳性，在血管上皮细胞中呈阴性；钙结合蛋白呈阴性。结果支持pCH合并慢性囊内自发性出血的诊断。随访期间未观察到并发症或复发。
pCH可能发生慢性自发性出血，这可能极大地影响使用成像方式诊断的准确性。对于不确定的pCH进行手术切除似乎是合理的，且预后良好。
