腹腔支气管源性囊肿8例临床分析

Clinicopathological features of intraabdominal bronchogenic cyst:an analysis of 8 cases

目的:分析腹腔支气管源性囊肿的临床特征及预后。方法:回顾临沧市人民医院、云南省肿瘤医院、大理大学第一附属医院2014年4月至2023年3月经手术完整切除囊壁并经病理确诊的腹腔支气管源性囊肿8例,分析其临床表现、实验室和辅助检查结果、治疗和预后。结果:8例患者中男性1例,女性7例,发病年龄21~65(45±12)岁。2例患者因腹痛就诊,5例患者因体检发现。8例患者囊肿均来源于腹腔,2例患者囊肿位于胰尾、脾脏及胃后壁之间,1例位于胃后壁,1例因肾上腺皮质腺瘤行手术治疗。2例患者肿瘤标志物升高,其余肿瘤标志物均正常。8例均行手术治疗,其中7例行腹腔镜下囊肿完整切除,1例开腹行囊肿切除。8例患者手术切除的病理标本肿瘤直径1.5~8.9 cm,平均5.6 cm。大部分囊肿囊壁内衬覆呼吸道上皮,由杯状细胞或假复层纤毛柱状上皮构成纤毛柱状上皮,囊壁为纤维结缔组织,或有平滑肌束,腔内含浆液黏液腺体。其中2例可见软骨组织,1例见大量炎性细胞浸润。手术切除后随访时间5~107个月,未见复发及转移病例。结论:腹腔支气管源性囊肿常于成年后被发现,诊断主要依靠病理检查,肿瘤标志物对其诊断无特异性,手术治疗效果较好。

Objective To analyze the clinicopathological features of intraabdominal bronchogenic cyst.Methods The clinical data of 8 patients with intraabdominal bronchogenic cyst admitted in 3 Grade-A tertiary hospitals in Yunnan province between 2014 and 2023 were retrospectively analyzed.The clinical and pathological features,diagnosis,treatment and prognosis of intraabdominal bronchogenic cyst were reviewed.Results There were 1 male and 7 females with an mean age of 45±12 years(21-65 years).Two patients presented with abdominal pain and 5 asymptomatic patients were found during physical examination.The cysts were located in retroperitoneum in 4 cases,located between the pancreas tail,spleen and the posterior wall of the stomach in 2 cases,located in the posterior wall of the stomach in 1 case,and located close to left adrenal gland in 1 case.Two patients had elevated tumor markers,while tumor markers in the remaining 6 cases were normal.Seven cases underwent laparoscopic complete cyst resection and 1 case had open surgical resection.The wall of most cysts were lined with respiratory epithelium and composed of goblet cells or pseudostratified ciliated columnar epithelium.The wall of cysts was composed of fibrous connective tissue or smooth muscle bundles,and the cavity contained serous mucous glands.Two cases showed cartilage tissue and one showed the infiltration of large number of inflammatory cells.The mean follow-up time was 31±32 months(range 5-107 months),and no recurrence or metastasis was found during the follow-up.Conclusions Abdominal bronchogenic cyst is often found in adulthood,and most cases are symptomatic and found during physical examination.The diagnosis mainly depends on pathological examination,and tumor markers are not specific for its diagnosis.Surgery is the best way for treatment.