CAJ | 학술논문

目的回顾性分析胰腺内副脾误诊病例,总结其误诊原因,以期提高其诊断正确率.方法收集复旦大学附属中山医院2005年4月至2013年12月间所有经病理证实为胰腺内副脾(IPAS)的病例,回顾性分析其临床资料,总结误诊的原因.结果收治的10例IPAS中,仅有1例获得术前正确诊断,其余9例误诊为无功能性神经内分泌瘤5例、神经内分泌癌3例、胰腺导管腺癌1例.9例误诊的IPAS均无特异性的症状及体征,常规实验室指标大致正常.本组9例IPAS均位于胰尾处,平均直径为(1.3 ±0.2)cm(0.8 ～2.5 cm),7例IPAS的CT及MRI强化方式均与脾脏高度相似,5例另见脾门周围副脾.结论影像学检查对IPAS诊断具有重要意义.与脾脏类同的强化方式为其特征性的影像学表现,“肿物”直径＜2.5 cm及伴有脾门周围副脾时应高度警惕IPAS的可能.
목적 회고성분석이선내부비오진병례,총결기오진원인,이기제고기진단정학솔.방법 수집복단대학부속중산의원2005년4월지2013년12월간소유경병리증실위이선내부비(IPAS)적병례,회고성분석기림상자료,총결오진적원인.결과 수치적10례IPAS중,부유1례획득술전정학진단,기여9례오진위무공능성신경내분비류5례、신경내분비암3례、이선도관선암1례.9례오진적IPAS균무특이성적증상급체정,상규실험실지표대치정상.본조9례IPAS균위우이미처,평균직경위(1.3 ±0.2)cm(0.8 ～2.5 cm),7례IPAS적CT급MRI강화방식균여비장고도상사,5례령견비문주위부비.결론 영상학검사대IPAS진단구유중요의의.여비장류동적강화방식위기특정성적영상학표현,“종물”직경＜2.5 cm급반유비문주위부비시응고도경척IPAS적가능.
Objective To promote the diagnostic accuracy of intrapancreatic accessory spleen (IPAS).Methods The clinical data of 10 cases of IPAS admitted in Fudan University Zhongshan Hospital from Apr 2005 to Dec 2013 were retrospectively analyzed.Results There were ten cases of IPAS confirmed pathologically.Only 1 of the ten cases was diagnosed correctly and definitely with IPAS preoperatively.The other 9 cases were misdiagnosed with benign or malignant pancreatic tumors,including nonfunctional neuroendocrine neoplasms in 5 cases,pancreatic neuroendocrine cancers in 3 and pancreatic intraductal adenocarcinoma in one.All the nine misdiagnosed patients has no specific symptoms or laboratory indexes.All the IPASs located in the tail of the pancreas with the mean diameter (1.3 ±0.2) cm(0.8-2.5 cm).7 cases of IPAS show strikingly similar dynamic enhancement to the spleen on the CT scans and/or MRI.Accessory spleen around the splenic hilum was found in five cases.Conclusions Morphological study plays an important role in the diagnosis and IPAS carries parallel dynamic enhancement to the spleen on CT scans and/or MRI.IPAS should be considered as a differential diagnosis while the lesion is no more than 2.5 cm in diameter and when other accessory spleens were shown around the splenic hilum.