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胰腺囊腺瘤是一罕见肿瘤,世界文献中约有300例报道。然而,医生应能识别这种肿瘤与其它胰腺肿瘤的不同,囊腺瘤的预后良好。如果及时诊断手术治疗,多数病人可获痊愈和缓解症状。病例报道、男,60岁,因胰尾部有一肿块来院治疗。确诊前主诉上腹部不适,发作了3个月伴水泻,过度排气,轻度发烧。同时有溶组织阿米巴和大肠杆菌感染。用抗阿米巴制剂和抗生素治疗。尽管持续治疗,嗜酸性白细胞持续升高,做腹部CT扫描,发现胰尾部有一多囊性肿块,6cm大小,临床诊断囊腺瘤剖腹发现在胰尾有多囊分叶肿块,切除肿块远端胰腺和脾脏。病理检查证实为微小浆液性囊腺瘤,6.5×3.9cm大小,分布在胰尾。显微镜下见肿瘤邻近正常胰腺有蜂窝状无数大小不等的囊肿,囊内复盖一层杯状上皮细胞,胞浆清晰,囊肿不产生粘液。肝脏有数个结节,组织学证实为干酪化肉芽肿。病人恢复平稳,术后第7天出院。
Pancreatic cystadenoma is a rare tumor that has been reported in about 300 cases in the world. However, doctors should be able to identify the difference between this type of tumor and other pancreatic tumors. The prognosis of cystadenoma is good. If the surgical treatment is diagnosed in time, most patients can recover and relieve symptoms. Case report, male, 60 years old, had a lump in the tail of the pancreas for treatment. He complained of upper abdominal discomfort before diagnosis, and had 3 months of episodes of watery diarrhea, excessive exhaust, and mild fever. There are both Entamoeba histolytica and E. coli infections. Treated with anti-amoebic agents and antibiotics. Although continuous treatment, eosinophilic leukocytes continued to increase, do abdominal CT scans, found that there is a polycystic mass in the pancreatic tail, 6cm in size, clinical diagnosis of cystadenoma laparotomy found in the pancreatic tail polycystic lobular mass, removal of the distal end of the mass Pancreas and spleen. Histopathological examination confirmed a small serous cystadenoma, 6.5 × 3.9cm in size, distributed in the pancreatic tail. Under the microscope, the tumor adjacent to the normal pancreas has honeycomb-like cysts of varying sizes. The capsule is covered with a cup-shaped epithelium with clear cytoplasm and the cyst does not produce mucus. There were several nodules in the liver, histologically confirmed to be granulomatous. The patient recovered steadily and was discharged on the seventh day after the operation.