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- 胰尾部囊肿(转帖)
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本帖最后由 于 2007-03-05 20:14:00 编辑
病史:22岁，女，无既往史，因贫血入院作进一步检查。. 无呕血等消化道出血的证据. 入院查体，面色略苍白，腹部稍微触及肿块. 化验,贫血(血红蛋白7.4g/dl,红细胞容积25. 2%，MCV85fl). 胃镜显示食管与胃静脉曲张，表面有结节，暗红出血点。 腹部CT发现胰腺尾部10cm囊性不规则病灶，囊壁厚薄不均。 轻度脾肿大、脾静脉阻塞、静脉曲张，胃及食管静脉也阻塞. 临床诊断：胰腺囊肿，手术摘除. 。大体检查：切除的胰尾部，囊肿大小10cm，单房性，充满清亮液体. 囊内壁光滑无结节. 切片为囊肿壁结构.
部分细胞好像有纤毛，胰腺少见的子宫内膜异位或子宫内膜样囊肿也要考虑。感觉此例主要是浆液性囊性肿瘤和子宫内膜异位的鉴别。等待学习。
胰腺浆液性囊性肿瘤包括：serous microcystic adenoma, serous oligocystic adenoma, rare solid serous adenoma and extremely rare von Hippel-Lindau-associated cystic neoplasm。
- the more we discuss, the more we learn from each other !!
| 以下是引用HHX 在2007-2-12 12:54:00的发言： 很想看看这个病例的肾和肝的影像学图片，不知能否提供？还有病史？ |
Clinical History:
A 22-year-old female with no medical history was admitted to our hospital for further examination of anemia. She had no evidence of gastrointestinal bleeding such as hematemesis. On admission, she was slightly pale and an abdominal mass was palpable. Laboratory examination confirmed the anemia (haemoglobin 7.4g/dl, hematocrit 25;2% and MCV 85 fl). Upper gastrointestinal endoscopy revealed nodular oesophageal and gastric varices with red spots suggesting stigmata of bleeding. On abdominal CT, the tail of the pancreas revealed a 10cm unilocular cystic lesion with irregular walls and septations. Mild splenomegaly, obstruction of splenic vein and gastrooesophageal varices were also observed. A clinical diagnosis of pancreatic cystadenocarcinoma was proposed. The patient underwent a distal pancreatectomy. Macroscopically, the tail of pancreas was occupied by a 10cm unilocular cyst showing numerous septa and filled with serosanguineous fluid. The inner lining of the cystic space did not show nodular masses. The selected slide concerns the cyst wall.
