Primary splenic epithelial cyst is an unusual event in everyday surgical practice with about 800 cases reported until date in the English literature. Splenic cysts may be parasitic or non-parasitic in origin. Nonparas...Primary splenic epithelial cyst is an unusual event in everyday surgical practice with about 800 cases reported until date in the English literature. Splenic cysts may be parasitic or non-parasitic in origin. Nonparasitic cysts are either primary or secondary. Primary cysts are also called true,congenital,epidermoid or epithelial cysts. Primary splenic cysts account for 10% of all benign non-parasitic splenic cysts and are the most frequent type of splenic cysts in children. Usually,splenic cysts are asymptomatic and can be found incidentally during imaging techniques or on laprotomy. The symptoms are related to the size of cysts. When they assume large sizes,they may present with fullness in the left abdomen,local or referred pain,symptoms due to compression of adjacent structures(like nausea,vomiting,flatulence,diarrhoea) or rarely thrombocytopenia,and occasionally complications such as infection,rupture and/or haemorrhage. The preoperative diagnosis of primary splenic cysts can be ascertained by ultrasonography(USG),computed tomography or magnetic resonance imaging,although the wide use of USG today has led to an increase in the incidence of splenic cysts by 1%. However,careful histopathological evaluation along with immunostaining for presence of epithelial lining is mandatory to arrive at the diagnosis. The treatment has changed drastically from total splenectomy in the past to splenic preservation methods recently.展开更多
Epidermoid cyst of intrapancreatic accessory spleen is exceedingly rare; only 30 new cases have been reported in the English literature over the last 30 years.An accurate preoperative diagnosis was made in almost none...Epidermoid cyst of intrapancreatic accessory spleen is exceedingly rare; only 30 new cases have been reported in the English literature over the last 30 years.An accurate preoperative diagnosis was made in almost none of them because of the lack of reliable preoperative diagnostic methods. In this report, we present a case diagnosed with fluorine-18 fluorodeoxyglucose positron emission tomography(FDG-PET). A 41-year-old female who had breast cancer was routinely followed up by measuring the concentration of tumor makers.An increasing level of serum carbohydrate antigen 19-9was detected and a cystic lesion located at the tail of pancreas was found by ultrasonography. A whole body fluorine-18 FDG positron emission tomography was performed because of a high suspicion for either a malignancy of the pancreas or a recurrence of breast cancer.No increased uptake of FDG was noted and therefore the cystic lesion was considered as pancreatic benign disease. Because pancreatic malignancy could not be entirely ruled out, distal pancreatectomy and splenectomy were performed. The final pathological diagnosiswas epidermoid cyst of intrapancreatic accessory spleen(ECIAS). The FDG-PET findings matched the histopathology. A literature review reveals that the common clinical manifestations of ECIAS include asymptomatic findings on clinical examination, an occasional increase in tumor makers on laboratory results and occurrence only in the pancreatic tail. It is often misdiagnosed due to its extreme rarity and lack of a specific radiographic sign. There is no evidence of malignancy in ECIAS. Open or laparoscopic spleen preserving distal pancreatectomy is the minimally invasive procedure that would provide the best surgical management for epidermoid cyst of intrapancreatic accessory spleen.展开更多
Aim: Discuss the different modalities of surgical treatment of splenic hydatid cyst and outcomes after treatment. Patients and Methods: Retrospectively, 14 patients were operated in our institution between 2002 and 20...Aim: Discuss the different modalities of surgical treatment of splenic hydatid cyst and outcomes after treatment. Patients and Methods: Retrospectively, 14 patients were operated in our institution between 2002 and 2011. Results: A total splenectomy was performed in 8 cases. A conservative treatment was preferred in 6 cases: 2 patients underwent partiel splenctomy and two patients underwent partial cystectomy. The duration of hospitalization ranged from 5 to 15 days. The morbidity rate was 14%. One patient presented a recurrent hemorrhage and one patient developed a left pneumonia. There is no death in our series. The mean duration follow-up was 20 months and there is no recurrence. Conclusion: Management of a splenic hydatid cyst is not consensual. Surgery remains the treatment of choice to avoid serious complications. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in some selected patients.展开更多
目的:观察细粒棘球蚴囊液对体外培养BALB/c小鼠脾细胞白介素(IL)-17和Smad2基因表达的影响。方法:制备小鼠脾细胞悬液,接种于48孔培养板中进行培养,以不加任何干预为对照组,囊液处理组为实验组。定时取样提取总RNA,经反转录成cDNA后用...目的:观察细粒棘球蚴囊液对体外培养BALB/c小鼠脾细胞白介素(IL)-17和Smad2基因表达的影响。方法:制备小鼠脾细胞悬液,接种于48孔培养板中进行培养,以不加任何干预为对照组,囊液处理组为实验组。定时取样提取总RNA,经反转录成cDNA后用实时荧光定量PCR(qRT-PCR)检测IL-17和Smad2基因的表达。结果:小鼠脾细胞IL-17表达在囊液处理6h和12h后升高(1.000±0.207 VS 3.672±0.746和1.000±0.154 VS 5.525±0.843),差异有统计学意义(P<0.05);小鼠脾细胞Smad2表达在培养1h后升高(1.000±0.077 VS 2.069±0.098)在12h后降低(1.000±0.110 VS 0.247±0.011),差异有统计学意义(P<0.05);协同分析发现IL-17基因与Smad2基因的表达变化呈现负相关(P<0.01),相关系数r=-1。结论:细粒棘球蚴囊液对小鼠脾细胞IL-17和Smad2基因的表达具有上调作用,推测其可能与宿主抗棘球蚴感染的机制有关。展开更多
文摘Primary splenic epithelial cyst is an unusual event in everyday surgical practice with about 800 cases reported until date in the English literature. Splenic cysts may be parasitic or non-parasitic in origin. Nonparasitic cysts are either primary or secondary. Primary cysts are also called true,congenital,epidermoid or epithelial cysts. Primary splenic cysts account for 10% of all benign non-parasitic splenic cysts and are the most frequent type of splenic cysts in children. Usually,splenic cysts are asymptomatic and can be found incidentally during imaging techniques or on laprotomy. The symptoms are related to the size of cysts. When they assume large sizes,they may present with fullness in the left abdomen,local or referred pain,symptoms due to compression of adjacent structures(like nausea,vomiting,flatulence,diarrhoea) or rarely thrombocytopenia,and occasionally complications such as infection,rupture and/or haemorrhage. The preoperative diagnosis of primary splenic cysts can be ascertained by ultrasonography(USG),computed tomography or magnetic resonance imaging,although the wide use of USG today has led to an increase in the incidence of splenic cysts by 1%. However,careful histopathological evaluation along with immunostaining for presence of epithelial lining is mandatory to arrive at the diagnosis. The treatment has changed drastically from total splenectomy in the past to splenic preservation methods recently.
文摘Epidermoid cyst of intrapancreatic accessory spleen is exceedingly rare; only 30 new cases have been reported in the English literature over the last 30 years.An accurate preoperative diagnosis was made in almost none of them because of the lack of reliable preoperative diagnostic methods. In this report, we present a case diagnosed with fluorine-18 fluorodeoxyglucose positron emission tomography(FDG-PET). A 41-year-old female who had breast cancer was routinely followed up by measuring the concentration of tumor makers.An increasing level of serum carbohydrate antigen 19-9was detected and a cystic lesion located at the tail of pancreas was found by ultrasonography. A whole body fluorine-18 FDG positron emission tomography was performed because of a high suspicion for either a malignancy of the pancreas or a recurrence of breast cancer.No increased uptake of FDG was noted and therefore the cystic lesion was considered as pancreatic benign disease. Because pancreatic malignancy could not be entirely ruled out, distal pancreatectomy and splenectomy were performed. The final pathological diagnosiswas epidermoid cyst of intrapancreatic accessory spleen(ECIAS). The FDG-PET findings matched the histopathology. A literature review reveals that the common clinical manifestations of ECIAS include asymptomatic findings on clinical examination, an occasional increase in tumor makers on laboratory results and occurrence only in the pancreatic tail. It is often misdiagnosed due to its extreme rarity and lack of a specific radiographic sign. There is no evidence of malignancy in ECIAS. Open or laparoscopic spleen preserving distal pancreatectomy is the minimally invasive procedure that would provide the best surgical management for epidermoid cyst of intrapancreatic accessory spleen.
文摘Aim: Discuss the different modalities of surgical treatment of splenic hydatid cyst and outcomes after treatment. Patients and Methods: Retrospectively, 14 patients were operated in our institution between 2002 and 2011. Results: A total splenectomy was performed in 8 cases. A conservative treatment was preferred in 6 cases: 2 patients underwent partiel splenctomy and two patients underwent partial cystectomy. The duration of hospitalization ranged from 5 to 15 days. The morbidity rate was 14%. One patient presented a recurrent hemorrhage and one patient developed a left pneumonia. There is no death in our series. The mean duration follow-up was 20 months and there is no recurrence. Conclusion: Management of a splenic hydatid cyst is not consensual. Surgery remains the treatment of choice to avoid serious complications. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in some selected patients.
文摘目的:观察细粒棘球蚴囊液对体外培养BALB/c小鼠脾细胞白介素(IL)-17和Smad2基因表达的影响。方法:制备小鼠脾细胞悬液,接种于48孔培养板中进行培养,以不加任何干预为对照组,囊液处理组为实验组。定时取样提取总RNA,经反转录成cDNA后用实时荧光定量PCR(qRT-PCR)检测IL-17和Smad2基因的表达。结果:小鼠脾细胞IL-17表达在囊液处理6h和12h后升高(1.000±0.207 VS 3.672±0.746和1.000±0.154 VS 5.525±0.843),差异有统计学意义(P<0.05);小鼠脾细胞Smad2表达在培养1h后升高(1.000±0.077 VS 2.069±0.098)在12h后降低(1.000±0.110 VS 0.247±0.011),差异有统计学意义(P<0.05);协同分析发现IL-17基因与Smad2基因的表达变化呈现负相关(P<0.01),相关系数r=-1。结论:细粒棘球蚴囊液对小鼠脾细胞IL-17和Smad2基因的表达具有上调作用,推测其可能与宿主抗棘球蚴感染的机制有关。
