Wirbel R J, Uhlig U, Futterer K M
Department of Surgery, St. Vincentius-Hospital, Karlsruhe, Germany.
Am J Med Sci. 1996 May;311(5):243-6. doi: 10.1097/00000441-199605000-00009.
Hamartomas of the spleen are rare benign tumors usually detected as asymptomatic, incidental findings at laparotomy or autopsy. By review of the literature, there are only 16 well-documented cases of symptomatic splenic hamartomas associated with hematologic disorders. The authors report on an additional case of splenic hamartoma in a 34-year-old man with thrombocytopenia. Findings by ultrasonography and computed tomography suggested multiple confluent splenic lesions. Because of progressively increasing thrombocytopenia, elective splenectomy was performed. Final pathology confirmed diagnosis of multiple hamartomas of the red pulp. Platelet count returned to normal within 1 month postoperatively. Differential diagnosis, diagnostic procedures, and pathologic findings of splenic hamartomas will be discussed. Hamartomas should be kept in mind in the differential diagnosis of splenic tumors. Splenectomy is indicated in cases where malignancy cannot be excluded and in cases of associated hematologic disorders.
脾脏错构瘤是罕见的良性肿瘤,通常在剖腹手术或尸检时作为无症状的偶然发现被检测到。通过文献回顾,仅有16例有充分记录的与血液系统疾病相关的有症状脾脏错构瘤病例。作者报告了另外1例34岁血小板减少男性的脾脏错构瘤病例。超声和计算机断层扫描结果提示脾脏有多个融合性病变。由于血小板减少症逐渐加重,遂行择期脾切除术。最终病理确诊为红髓型多发性错构瘤。术后1个月内血小板计数恢复正常。将讨论脾脏错构瘤的鉴别诊断、诊断方法及病理表现。在脾脏肿瘤的鉴别诊断中应考虑到错构瘤。当不能排除恶性肿瘤以及存在相关血液系统疾病时,建议行脾切除术。