Fujita Minoru, Manabe Noriaki, Ayaki Maki, Bukeo-Uji Emiko, Konishi Takako, Nakamura Jun, Katsumata Ryo, Murao Takahisa, Suehiro Mitsuhiko, Fujiwara Hideyo, Monobe Yasumasa, Takaoka Munenori, Kato Katsuya, Kawamoto Hirofumi, Kamada Tomoari, Urakami Atsushi, Yamatsuji Tomoki, Naomoto Yoshio, Haruma Ken, Hata Jiro
Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
Department of Gastroenterology and Hepatology, HITO Medical Center, Shikokuchuou, Japan.
Radiol Case Rep. 2024 Jan 4;19(3):1166-1170. doi: 10.1016/j.radcr.2023.12.033. eCollection 2024 Mar.
We report a patient with a mucocele with diffuse wall thickening diagnosed by transabdominal ultrasonography and contrast-enhanced ultrasonography. Transabdominal ultrasonography showed diffuse thickening of the entire appendix wall and an anechoic area that appeared to be fluid collected throughout the appendix lumen. However, the "onion skin sign" was not detected. Contrast-enhanced ultrasonography combined with superb microvascular imaging revealed abundant mucosal blood flow and no abnormal vascular network within the mucosa of the appendix wall. We preoperatively diagnosed a mucocele complicated by acute and chronic appendicitis, and ileocecal resection was performed. Macroscopic and microscopic findings of the resected specimens demonstrated that the appendiceal wall was diffusely thickened, with fibrosis and inflammatory cell infiltration, and that the appendiceal root rumen was narrowed with epithelial hyperplasia. No neoplastic changes were observed. The cause of the appendiceal mucocele was likely fibrosis and stenosis at the root of the appendix due to initial acute appendicitis.
我们报告一例经腹部超声和超声造影诊断为伴有弥漫性壁增厚的黏液囊肿患者。经腹部超声显示整个阑尾壁弥漫性增厚，阑尾腔内可见一液性无回声区。然而，未检测到“洋葱皮征”。超声造影联合超微血管成像显示阑尾壁黏膜血流丰富，黏膜内无异常血管网。我们术前诊断为黏液囊肿合并急性和慢性阑尾炎，并进行了回盲部切除术。切除标本的宏观和微观检查结果显示，阑尾壁弥漫性增厚，伴有纤维化和炎性细胞浸润，阑尾根部瘤腔狭窄，上皮增生。未观察到肿瘤性改变。阑尾黏液囊肿的病因可能是最初的急性阑尾炎导致阑尾根部纤维化和狭窄。
