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被误诊为胰腺肿瘤的巨大转移性淋巴结:一例报告

Large metastatic lymph nodes misdiagnosed as a pancreatic tumor: a case report.

作者信息

Duan Qiong, Huang Yanan, Li He

机构信息

Department of General Surgery, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang Road, Zhongshan District, Dalian City 116001, PR China.

出版信息

J Surg Case Rep. 2025 Aug 1;2025(7):rjaf583. doi: 10.1093/jscr/rjaf583. eCollection 2025 Jul.

Abstract

Due to the anatomical proximity between pancreatic tumors and the group 8 lymph nodes of the stomach, misdiagnosis can easily occur. The patient's preoperative examination: computed tomography (CT) scan examination indicated an abdominal mass, 3.0T pancreatic magnetic resonance imaging (MRI) with contrast enhancement showed a pancreatic head lesion, possibly a neuroendocrine tumor. Gastroscopy revealed highly suspicious for cancer. Pancreaticoduodenectomy was planned. However, intraoperative exploration revealed the tumor to be localized within the Group 8 lymph nodes rather than the pancreas. Radical distal gastrectomy, along with resection of the lymph node mass, was performed. Histopathological analysis confirmed early gastric cancer with metastatic lymph node involvement. This case highlights a diagnostic pitfall wherein gastric cancer with lymph node metastasis was mistaken for a pancreatic tumor due to their anatomical overlap.

摘要

由于胰腺肿瘤与胃的第8组淋巴结在解剖位置上相邻,很容易发生误诊。患者术前检查:计算机断层扫描(CT)检查显示腹部有肿块,3.0T胰腺磁共振成像(MRI)增强扫描显示胰头有病变,可能是神经内分泌肿瘤。胃镜检查显示高度怀疑为癌症。计划进行胰十二指肠切除术。然而,术中探查发现肿瘤位于第8组淋巴结内,而非胰腺。遂进行了根治性远端胃切除术,并切除了淋巴结肿块。组织病理学分析证实为早期胃癌伴淋巴结转移。该病例突出了一个诊断陷阱,即由于解剖位置重叠,伴有淋巴结转移的胃癌被误诊为胰腺肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed99/12315533/068b6490b8ee/rjaf583f1.jpg

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