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Epidermoid cyst of spleen mimicking splenic lymphangioma

机译:脾样表皮样囊肿样脾淋巴管瘤

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Primary splenic cyst is a relatively rare entity; they comprise only about 10% of benign non-parasitic cysts. Most of these are asymptomatic and are observed incidentally during abdominal ultrasonography. The number of diagnosed splenic cyst cases seems to have risen because of the increasing use of abdominal imaging techniques. However, definite diagnosis is possible only after splenectomy when epithelial lining is confirmed histologically. We report a case of a 14-year-old child who presented with fullness of abdomen and pain in the left hypochondrium since last few months. First impression made was in favor of a splenic lymphangioma of size 8 × 8 cm which was based on a Computerized tomography scan and the sonographic findings. Splenectomy was performed and was sent for histopathological examination which in combination with immunohistochemistry revealed findings suggestive of primary epithelial cyst. A large cystic mass with a relatively thin wall localized in the spleen is likely to be a primary or secondary cyst. The diagnosis of false cyst should be favored if there is a clear history of trauma, if the patient is older than fourth decade, if there is a hematoma elsewhere in spleen, or if cyst wall is calcified. This rare entity should be considered in the differential diagnosis in a patient presenting with left hypochondrial pain.
机译:原发性脾囊肿是相对罕见的实体。它们仅包含约10%的良性非寄生虫囊肿。这些大多数无症状,在腹部超声检查中偶然发现。由于腹部成像技术的日益普及,确诊的脾囊肿病例数似乎有所增加。但是,只有在脾切除后,如果从组织学上证实上皮衬里,才可以进行明确的诊断。我们报告了一个病例,该病例为一个14岁的孩子,自最近几个月以来,其腹部左腹软骨饱满且疼痛。第一印象是基于计算机断层扫描和超声检查结果的大小为8×8 cm的脾淋巴管瘤。进行脾切除术并送去进行组织病理学检查,结合免疫组织化学发现提示原发性上皮囊肿。脾脏壁较薄的较大囊性肿块很可能是原发性或继发性囊肿。如果有明确的外伤史,患者年龄超过四十岁,脾脏其他地方有血肿或囊壁钙化,则应首选假囊肿的诊断。在患有左软骨下痛的患者的鉴别诊断中应考虑这种罕见的实体。

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