Zhai Kui, Miao Xingpeng, Xue Guiling, Yuan Zhanyu, Jia Mao, Chen Mingyan, Zha Renzhong
Department of Thoracic Surgery, People's Hospital of Xingyi City, Xingyi, Guizhou, China.
Department of Pathology, People's Hospital of Xingyi City, Xingyi, Guizhou, China.
Front Pediatr. 2025 Jul 2;13:1613764. doi: 10.3389/fped.2025.1613764. eCollection 2025.
Mediastinal lesions have diverse etiologies, with thymoma, cystic teratoma, and lymphoma being relatively prevalent. In contrast, a pancreatic pseudocyst within the mediastinum is exceedingly rare and can often be mistaken for a thymic cyst or teratoma.
A 17-year-old female presented with a cough and sputum production. Chest CT revealed an anterior mediastinal mass, initially raising the suspicion of a thymic cyst. Thoracoscopic exploration and resection revealed a cystic lesion with a thick wall and brownish fluid. Both frozen section and final histopathological analysis confirmed a mediastinal cyst. Immunohistochemical markers (SYN positive, CK7 positive) led to a diagnosis of mediastinal pancreatic pseudocyst. The patient experienced significant recovery post-surgery, with a marked improvement in symptoms.
This case highlights the importance of including mediastinal pancreatic pseudocyst in the differential diagnosis of anterior mediastinal cystic lesions. A thorough clinical and radiological assessment, along with surgical pathology and immunohistochemical profiling, is essential for accurate diagnosis and appropriate management.
纵隔病变病因多样，胸腺瘤、囊性畸胎瘤和淋巴瘤相对常见。相比之下，纵隔内胰腺假性囊肿极为罕见，常被误诊为胸腺囊肿或畸胎瘤。
一名17岁女性出现咳嗽和咳痰症状。胸部CT显示前纵隔肿块，最初怀疑为胸腺囊肿。胸腔镜探查和切除发现一个壁厚且含有褐色液体的囊性病变。冰冻切片和最终组织病理学分析均证实为纵隔囊肿。免疫组化标记物（SYN阳性，CK7阳性）诊断为纵隔胰腺假性囊肿。患者术后恢复良好，症状明显改善。
本病例强调了在鉴别诊断前纵隔囊性病变时纳入纵隔胰腺假性囊肿的重要性。全面的临床和影像学评估，以及手术病理和免疫组化分析，对于准确诊断和恰当处理至关重要。
