We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admi...We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admitted for abdominal pain in the epigastrium, with irradiation to the right hypochondrium, accompanied by nausea and vomiting of 10 occasions of bile content, physical examination with pain in the right hypochondrium, Murphy positive. We have laboratory studies with a lipase of 788, so a diagnosis of pancreatitis is made with an etiology to be determined. The laboratories suggestive of acute biliary pancreatitis (lipase 788.71);an imaging study was subsequently performed (ultrasonography) with the result of stone in the common bile duct. A laparoscopy was performed with relative improvement, so he was discharged and returned 20 days after surgery due to abdominal pain of the same intensity in the left hypochondrium. Ending his hospitalization with a splenectomy for splenic hemangioma with portal vein thrombosis.展开更多
Neutron radiography is a crucial nondestructive testing technology widely used in the aerospace,military,and nuclear industries.However,because of the physical limitations of neutron sources and collimators,the result...Neutron radiography is a crucial nondestructive testing technology widely used in the aerospace,military,and nuclear industries.However,because of the physical limitations of neutron sources and collimators,the resulting neutron radiographic images inevitably exhibit multiple distortions,including noise,geometric unsharpness,and white spots.Furthermore,these distortions are particularly significant in compact neutron radiography systems with low neutron fluxes.Therefore,in this study,we devised a multi-distortion suppression network that employs a modified generative adversarial network to improve the quality of degraded neutron radiographic images.Real neutron radiographic image datasets with various types and levels of distortion were built for the first time as multi-distortion suppression datasets.Thereafter,the coordinate attention mechanism was incorporated into the backbone network to augment the capability of the proposed network to learn the abstract relationship between ideally clear and degraded images.Extensive experiments were performed;the results show that the proposed method can effectively suppress multiple distortions in real neutron radiographic images and achieve state-of-theart perceptual visual quality,thus demonstrating its application potential in neutron radiography.展开更多
Artificial intelligence(AI)and deep learning are becoming increasingly powerful tools in diagnostic and radiographic medicine.Deep learning has already been utilized for automated detection of pneumonia from chest rad...Artificial intelligence(AI)and deep learning are becoming increasingly powerful tools in diagnostic and radiographic medicine.Deep learning has already been utilized for automated detection of pneumonia from chest radiographs,diabetic retinopathy,breast cancer,skin carcinoma classification,and metastatic lymphadenopathy detection,with diagnostic reliability akin to medical experts.In the World Journal of Orthopedics article,the authors apply an automated and AIassisted technique to determine the hallux valgus angle(HVA)for assessing HV foot deformity.With the U-net neural network,the authors constructed an algorithm for pattern recognition of HV foot deformity from anteroposterior highresolution radiographs.The performance of the deep learning algorithm was compared to expert clinician manual performance and assessed alongside clinician-clinician variability.The authors found that the AI tool was sufficient in assessing HVA and proposed the system as an instrument to augment clinical efficiency.Though further sophistication is needed to establish automated algorithms for more complicated foot pathologies,this work adds to the growing evidence supporting AI as a powerful diagnostic tool.展开更多
BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as colitis.Surgical resection is currently the mainstay of ...BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as colitis.Surgical resection is currently the mainstay of treatment,with an emphasis on sphincter preservation.CASE SUMMARY We present details of two young patients with a history of persistent hematochezia diagnosed with colorectal cavernous hemangioma by endoscopic ultrasound(EUS).Cavernous hemangioma was relieved by several EUS-guided lauromacrogol injections and the patients achieved favorable clinical prognosis.CONCLUSION Multiple sequential EUS-guided injections of lauromacrogol is a safe,effective,cost-efficient,and minimally invasive alternative for colorectal cavernous hemangioma.展开更多
Owing to the immobility of traditional reactors and spallation neutron sources,the demand for compact thermal neutron radiography(CTNR)based on accelerator neutron sources has rapidly increased in industrial applicati...Owing to the immobility of traditional reactors and spallation neutron sources,the demand for compact thermal neutron radiography(CTNR)based on accelerator neutron sources has rapidly increased in industrial applications.Recently,thermal neutron radiography experiments based on a D-T neutron generator performed by Hefei Institutes of Physical Science indicated a significant resolution deviation between the experimental results and the values calculated using the traditional resolution model.The experimental result was up to 23%lower than the calculated result,which hinders the achievement of the design goal of a compact neutron radiography system.A GEANT4 Monte Carlo code was developed to simulate the CTNR process,aiming to identify the key factors leading to resolution deviation.The effects of a low collimation ratio and high-energy neutrons were analyzed based on the neutron beam environment of the CTNR system.The results showed that the deviation was primarily caused by geometric distortion at low collimation ratios and radiation noise induced by highenergy neutrons.Additionally,the theoretical model was modified by considering the imaging position and radiation noise factors.The modified theoretical model was in good agreement with the experimental results,and the maximum deviation was reduced to 4.22%.This can be useful for the high-precision design of CTNR systems.展开更多
BACKGROUND Giant hepatic cavernous hemangioma with multiple satellite nodules is a rare subtype of hepatic cavernous hemangioma,the most common vascular liver tumor.We report on a tumor with unusual histologic feature...BACKGROUND Giant hepatic cavernous hemangioma with multiple satellite nodules is a rare subtype of hepatic cavernous hemangioma,the most common vascular liver tumor.We report on a tumor with unusual histologic features:(1)Finger-like infiltration pattern;(2)lack of encapsulation;(3)blurred tumor/liver interface;and(4)massive satellitosis-referring to the article“Hepatic cavernous hemangioma:underrecognized associated histologic features”.CASE SUMMARY A 60-year-old man presented with increasing uncharacteristic abdominal discomfort and mildly elevated blood parameters of acute inflammation.Imaging revealed an unclear,giant liver tumor of the left liver lobe.A massive vascular tumor with extensive satellitosis broadly infiltrating the adjacent liver parenchyma was resected via hemihepatectomy of segmentsⅡ/Ⅲ.Histopathological diagnosis was giant hepatic cavernous hemangioma with multiple satellite nodules,featuring unusual characteristics hardly portrayed in the literature.Retrospectively,this particular morphology can explain the difficult pre-and perioperative diagnosis of a vascular liver tumor that is usually readily identifiable by modern imaging methods.CONCLUSION This case emphasizes the exact histological workup of tumor and tumor-induced parenchyma changes in radiologically unclassifiable liver tumors.展开更多
BACKGROUND Primary abdominal and retroperitoneal cavernous hemangioma is a vascular tumor and rarely seen in the clinic.Due to the lack of specific imaging features,retroperitoneal cavernous hemangioma cannot be diagn...BACKGROUND Primary abdominal and retroperitoneal cavernous hemangioma is a vascular tumor and rarely seen in the clinic.Due to the lack of specific imaging features,retroperitoneal cavernous hemangioma cannot be diagnosed accurately.Some symptoms may develop with the enlargement of lesion volume or the occurrence of complications such as rupture or oppression.We report here a special case who was admitted with chronic abdominal pain.Admission examination suggested a retroperitoneal lymphatic duct cyst.Laparoscopic resection of the retroperitoneal mass was performed,and histological examination confirmed retroperitoneal cavernous hemangioma.CASE SUMMARY The patient was a 43-year-old Tibetan woman with intermittent left lower abdominal pain and discomfort 3 years ago.Ultrasonography revealed a cystic mass in the retroperitoneum with clear boundaries,internal septa,and no blood flow signal.Computed tomography(CT)and magnetic resonance imaging(MRI)showed an irregular space-occupying mass in the retroperitoneum,and retroperitoneal lymphatic cyst was considered.Plain CT scanning showed multiple cystlike hypo-intense shadows in the retroperitoneum,partially fused into a mass,and no obvious enhancement was found on enhanced scanning.MRI showed multiple irregular clump-like long T1 and long T2 signal shadows above the pancreas,within which linear short T2 signal shadows were seen.Diffusionweighted imaging sequence showed hypo-signal shadows,without obvious enhancement on enhanced scanning.Ultrasound,CT,and MRI all suggested the possibility of retroperitoneal lymphatic cyst.However,the patient was finally diagnosed with retroperitoneal cavernous hemangioma by pathological examination.CONCLUSION Retroperitoneal cavernous hemangioma is a benign lesion,and it is difficult to make a diagnosis preoperatively.Surgical resection may be the only treatment,which not only allows histopathological confirmation as a diagnostic purpose and excludes any risk of malignancy,but also avoids invasion of adjacent tissues,oppression,and other complications as a therapeutic goal.展开更多
BACKGROUND Postoperative complications of triceps surae intramuscular hemangioma surgery with talipes equinovarus have rarely been described,and the evidence for treatment is limited.The purpose of this case study was...BACKGROUND Postoperative complications of triceps surae intramuscular hemangioma surgery with talipes equinovarus have rarely been described,and the evidence for treatment is limited.The purpose of this case study was to report the new application of the Ilizarov technique,which successfully treated talipes equinovarus in adults after triceps surae intramuscular hemangioma.CASE SUMMARY A 29-year-old woman treated with the Ilizarov technique for talipes equinovarus in the right leg after triceps surae intramuscular hemangioma surgery.The equinus deformity was roughly corrected after 2 years of follow-up,without significant secondary sequelae.CONCLUSION Talipes equinovarus caused by postoperative sequelae of intramuscular hemangioma was successfully corrected by the Ilizarov technique.The Ilizarov technique may be used for treating talipes equinovarus caused by various causes.展开更多
Infantile hemangiomas(IHs) are the most common benign soft-tissue tumors in infancy;about 10%–15% of them may result in various complications that require active management. The current first-line treatment for IH is...Infantile hemangiomas(IHs) are the most common benign soft-tissue tumors in infancy;about 10%–15% of them may result in various complications that require active management. The current first-line treatment for IH is oral propranolol;however, some studies recommend intralesional corticosteroid injections for small, limited, deep, or prominent tumors because of concern regarding serious systemic complications related to propranolol. This review summarizes and analyzes the current clinical studies on corticosteroid injections in IHs, discusses treatment norms, and explores future research directions.展开更多
BACKGROUND Congenital infantile fibrosarcoma(CIF)and congenital hemangioma(CH)have similarities on prenatal ultrasound and are rare.CASE SUMMARY We report 3 cases of fetuses with superficial hypervascular tumors,confi...BACKGROUND Congenital infantile fibrosarcoma(CIF)and congenital hemangioma(CH)have similarities on prenatal ultrasound and are rare.CASE SUMMARY We report 3 cases of fetuses with superficial hypervascular tumors,confirmed by postnatal pathology as CIF(1 case)and CH(2 cases,including 1 in a twin fetus).In Case 1,a mass with a rich blood supply in the fetal axilla was discovered by prenatal ultrasound at 28+0 wk of gestation.The postpartum pathological diagnosis was CIF,the mass was surgically removed,and the prognosis of the child was good.In Case 2,at 23+1 wk of gestation,a mass was discovered at the base of the fetus’s thigh on prenatal ultrasound.The postpartum pathological diagnosis was CH.After conservative treatment,the mass shrank significantly.Case 3 occurred in a twin fetus.At 30+0 wk of gestation,prenatal ultrasound revealed a bulging mass with a rich blood supply on the abdominal wall of one of the fetuses.Three weeks later,the affected fetus died,and the unaffected baby was successfully delivered by emergency cesarean section.The affected fetus was pathologically diagnosed with CH.CONCLUSION Prenatal ultrasound can provide accurate information,such as the location,size and blood supply of a surface mass in a fetus.We found similarities between CIF and CH in prenatal ultrasound findings.Although it is difficult to distinguish these conditions by prenatal ultrasound alone,for superficial hypervascular tumors that rapidly increase in size in a short period,close ultrasound monitoring of the fetus is required to quickly address possible adverse outcomes.展开更多
BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to ...BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.CASE SUMMARY We describe a male patient,age 18,who presented with a pCH.Computed tomography,magnetic resonance imaging,and ultrasound showed cystic space in the tail of the pancreas.A dark spot sign on the T2 weighted image sequence was observed.Clinically,a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging,and the operative indication was clear.The patient underwent a distal pancreatic tumor resection under laparoscopic control.Immunohistochemical staining for CD31 and CD34 was positive;D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells;and calcium-binding protein was negative.The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage.No complications or recurrences were observed during the follow-up period.CONCLUSION Chronic spontaneous hemorrhage may occur in pCH,which may greatly influence the accuracy of diagnosis using imaging modalities.Surgical resection for uncertain pCH seems reasonable with a good outcome.展开更多
文摘We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admitted for abdominal pain in the epigastrium, with irradiation to the right hypochondrium, accompanied by nausea and vomiting of 10 occasions of bile content, physical examination with pain in the right hypochondrium, Murphy positive. We have laboratory studies with a lipase of 788, so a diagnosis of pancreatitis is made with an etiology to be determined. The laboratories suggestive of acute biliary pancreatitis (lipase 788.71);an imaging study was subsequently performed (ultrasonography) with the result of stone in the common bile duct. A laparoscopy was performed with relative improvement, so he was discharged and returned 20 days after surgery due to abdominal pain of the same intensity in the left hypochondrium. Ending his hospitalization with a splenectomy for splenic hemangioma with portal vein thrombosis.
基金supported by National Natural Science Foundation of China(Nos.11905028,12105040)Scientific Research Project of Education Department of Jilin Province(No.JJKH20231294KJ)。
文摘Neutron radiography is a crucial nondestructive testing technology widely used in the aerospace,military,and nuclear industries.However,because of the physical limitations of neutron sources and collimators,the resulting neutron radiographic images inevitably exhibit multiple distortions,including noise,geometric unsharpness,and white spots.Furthermore,these distortions are particularly significant in compact neutron radiography systems with low neutron fluxes.Therefore,in this study,we devised a multi-distortion suppression network that employs a modified generative adversarial network to improve the quality of degraded neutron radiographic images.Real neutron radiographic image datasets with various types and levels of distortion were built for the first time as multi-distortion suppression datasets.Thereafter,the coordinate attention mechanism was incorporated into the backbone network to augment the capability of the proposed network to learn the abstract relationship between ideally clear and degraded images.Extensive experiments were performed;the results show that the proposed method can effectively suppress multiple distortions in real neutron radiographic images and achieve state-of-theart perceptual visual quality,thus demonstrating its application potential in neutron radiography.
文摘Artificial intelligence(AI)and deep learning are becoming increasingly powerful tools in diagnostic and radiographic medicine.Deep learning has already been utilized for automated detection of pneumonia from chest radiographs,diabetic retinopathy,breast cancer,skin carcinoma classification,and metastatic lymphadenopathy detection,with diagnostic reliability akin to medical experts.In the World Journal of Orthopedics article,the authors apply an automated and AIassisted technique to determine the hallux valgus angle(HVA)for assessing HV foot deformity.With the U-net neural network,the authors constructed an algorithm for pattern recognition of HV foot deformity from anteroposterior highresolution radiographs.The performance of the deep learning algorithm was compared to expert clinician manual performance and assessed alongside clinician-clinician variability.The authors found that the AI tool was sufficient in assessing HVA and proposed the system as an instrument to augment clinical efficiency.Though further sophistication is needed to establish automated algorithms for more complicated foot pathologies,this work adds to the growing evidence supporting AI as a powerful diagnostic tool.
基金Supported by Natural Science Foundation of Zhejiang Province,No.LY20H030010Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2019-KY1-001-181.
文摘BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as colitis.Surgical resection is currently the mainstay of treatment,with an emphasis on sphincter preservation.CASE SUMMARY We present details of two young patients with a history of persistent hematochezia diagnosed with colorectal cavernous hemangioma by endoscopic ultrasound(EUS).Cavernous hemangioma was relieved by several EUS-guided lauromacrogol injections and the patients achieved favorable clinical prognosis.CONCLUSION Multiple sequential EUS-guided injections of lauromacrogol is a safe,effective,cost-efficient,and minimally invasive alternative for colorectal cavernous hemangioma.
基金supported by the Nuclear Energy Development Project of China (No.[2019]1342)the Presidential Foundation of HFIPS (No.YZJJ2022QN40)。
文摘Owing to the immobility of traditional reactors and spallation neutron sources,the demand for compact thermal neutron radiography(CTNR)based on accelerator neutron sources has rapidly increased in industrial applications.Recently,thermal neutron radiography experiments based on a D-T neutron generator performed by Hefei Institutes of Physical Science indicated a significant resolution deviation between the experimental results and the values calculated using the traditional resolution model.The experimental result was up to 23%lower than the calculated result,which hinders the achievement of the design goal of a compact neutron radiography system.A GEANT4 Monte Carlo code was developed to simulate the CTNR process,aiming to identify the key factors leading to resolution deviation.The effects of a low collimation ratio and high-energy neutrons were analyzed based on the neutron beam environment of the CTNR system.The results showed that the deviation was primarily caused by geometric distortion at low collimation ratios and radiation noise induced by highenergy neutrons.Additionally,the theoretical model was modified by considering the imaging position and radiation noise factors.The modified theoretical model was in good agreement with the experimental results,and the maximum deviation was reduced to 4.22%.This can be useful for the high-precision design of CTNR systems.
文摘BACKGROUND Giant hepatic cavernous hemangioma with multiple satellite nodules is a rare subtype of hepatic cavernous hemangioma,the most common vascular liver tumor.We report on a tumor with unusual histologic features:(1)Finger-like infiltration pattern;(2)lack of encapsulation;(3)blurred tumor/liver interface;and(4)massive satellitosis-referring to the article“Hepatic cavernous hemangioma:underrecognized associated histologic features”.CASE SUMMARY A 60-year-old man presented with increasing uncharacteristic abdominal discomfort and mildly elevated blood parameters of acute inflammation.Imaging revealed an unclear,giant liver tumor of the left liver lobe.A massive vascular tumor with extensive satellitosis broadly infiltrating the adjacent liver parenchyma was resected via hemihepatectomy of segmentsⅡ/Ⅲ.Histopathological diagnosis was giant hepatic cavernous hemangioma with multiple satellite nodules,featuring unusual characteristics hardly portrayed in the literature.Retrospectively,this particular morphology can explain the difficult pre-and perioperative diagnosis of a vascular liver tumor that is usually readily identifiable by modern imaging methods.CONCLUSION This case emphasizes the exact histological workup of tumor and tumor-induced parenchyma changes in radiologically unclassifiable liver tumors.
基金Supported by Health Commission of Qinghai Province,No.2020-wjzdx-28.
文摘BACKGROUND Primary abdominal and retroperitoneal cavernous hemangioma is a vascular tumor and rarely seen in the clinic.Due to the lack of specific imaging features,retroperitoneal cavernous hemangioma cannot be diagnosed accurately.Some symptoms may develop with the enlargement of lesion volume or the occurrence of complications such as rupture or oppression.We report here a special case who was admitted with chronic abdominal pain.Admission examination suggested a retroperitoneal lymphatic duct cyst.Laparoscopic resection of the retroperitoneal mass was performed,and histological examination confirmed retroperitoneal cavernous hemangioma.CASE SUMMARY The patient was a 43-year-old Tibetan woman with intermittent left lower abdominal pain and discomfort 3 years ago.Ultrasonography revealed a cystic mass in the retroperitoneum with clear boundaries,internal septa,and no blood flow signal.Computed tomography(CT)and magnetic resonance imaging(MRI)showed an irregular space-occupying mass in the retroperitoneum,and retroperitoneal lymphatic cyst was considered.Plain CT scanning showed multiple cystlike hypo-intense shadows in the retroperitoneum,partially fused into a mass,and no obvious enhancement was found on enhanced scanning.MRI showed multiple irregular clump-like long T1 and long T2 signal shadows above the pancreas,within which linear short T2 signal shadows were seen.Diffusionweighted imaging sequence showed hypo-signal shadows,without obvious enhancement on enhanced scanning.Ultrasound,CT,and MRI all suggested the possibility of retroperitoneal lymphatic cyst.However,the patient was finally diagnosed with retroperitoneal cavernous hemangioma by pathological examination.CONCLUSION Retroperitoneal cavernous hemangioma is a benign lesion,and it is difficult to make a diagnosis preoperatively.Surgical resection may be the only treatment,which not only allows histopathological confirmation as a diagnostic purpose and excludes any risk of malignancy,but also avoids invasion of adjacent tissues,oppression,and other complications as a therapeutic goal.
基金Supported by Zhangzhou Natural Science Foundation Projects in 2019,No.ZZ2019J19。
文摘BACKGROUND Postoperative complications of triceps surae intramuscular hemangioma surgery with talipes equinovarus have rarely been described,and the evidence for treatment is limited.The purpose of this case study was to report the new application of the Ilizarov technique,which successfully treated talipes equinovarus in adults after triceps surae intramuscular hemangioma.CASE SUMMARY A 29-year-old woman treated with the Ilizarov technique for talipes equinovarus in the right leg after triceps surae intramuscular hemangioma surgery.The equinus deformity was roughly corrected after 2 years of follow-up,without significant secondary sequelae.CONCLUSION Talipes equinovarus caused by postoperative sequelae of intramuscular hemangioma was successfully corrected by the Ilizarov technique.The Ilizarov technique may be used for treating talipes equinovarus caused by various causes.
基金supported by the National Nature Science Foundation of China (grant no. 82272288)。
文摘Infantile hemangiomas(IHs) are the most common benign soft-tissue tumors in infancy;about 10%–15% of them may result in various complications that require active management. The current first-line treatment for IH is oral propranolol;however, some studies recommend intralesional corticosteroid injections for small, limited, deep, or prominent tumors because of concern regarding serious systemic complications related to propranolol. This review summarizes and analyzes the current clinical studies on corticosteroid injections in IHs, discusses treatment norms, and explores future research directions.
文摘BACKGROUND Congenital infantile fibrosarcoma(CIF)and congenital hemangioma(CH)have similarities on prenatal ultrasound and are rare.CASE SUMMARY We report 3 cases of fetuses with superficial hypervascular tumors,confirmed by postnatal pathology as CIF(1 case)and CH(2 cases,including 1 in a twin fetus).In Case 1,a mass with a rich blood supply in the fetal axilla was discovered by prenatal ultrasound at 28+0 wk of gestation.The postpartum pathological diagnosis was CIF,the mass was surgically removed,and the prognosis of the child was good.In Case 2,at 23+1 wk of gestation,a mass was discovered at the base of the fetus’s thigh on prenatal ultrasound.The postpartum pathological diagnosis was CH.After conservative treatment,the mass shrank significantly.Case 3 occurred in a twin fetus.At 30+0 wk of gestation,prenatal ultrasound revealed a bulging mass with a rich blood supply on the abdominal wall of one of the fetuses.Three weeks later,the affected fetus died,and the unaffected baby was successfully delivered by emergency cesarean section.The affected fetus was pathologically diagnosed with CH.CONCLUSION Prenatal ultrasound can provide accurate information,such as the location,size and blood supply of a surface mass in a fetus.We found similarities between CIF and CH in prenatal ultrasound findings.Although it is difficult to distinguish these conditions by prenatal ultrasound alone,for superficial hypervascular tumors that rapidly increase in size in a short period,close ultrasound monitoring of the fetus is required to quickly address possible adverse outcomes.
文摘BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.CASE SUMMARY We describe a male patient,age 18,who presented with a pCH.Computed tomography,magnetic resonance imaging,and ultrasound showed cystic space in the tail of the pancreas.A dark spot sign on the T2 weighted image sequence was observed.Clinically,a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging,and the operative indication was clear.The patient underwent a distal pancreatic tumor resection under laparoscopic control.Immunohistochemical staining for CD31 and CD34 was positive;D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells;and calcium-binding protein was negative.The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage.No complications or recurrences were observed during the follow-up period.CONCLUSION Chronic spontaneous hemorrhage may occur in pCH,which may greatly influence the accuracy of diagnosis using imaging modalities.Surgical resection for uncertain pCH seems reasonable with a good outcome.
