中国寄生虫学与寄生虫病杂志 ›› 2025, Vol. 43 ›› Issue (1): 152-154.doi: 10.12140/j.issn.1000-7423.2025.01.025

• 病例报告 • 上一篇    

误诊为胰腺浆液性囊腺瘤的胰腺细粒棘球蚴病1例

刘校伸1(), 王灏1, 杜磊1, 樊海宁1,2, 郭新建3, 马倩源3, 任利1,2,*()   

  1. 1 青海大学附属医院肝胆胰外科,青海 西宁 810001
    2 青海省包虫病研究重点实验室,青海 西宁 810001
    3 青海大学附属医院病理科,青海 西宁 810001
  • 收稿日期:2024-08-06 修回日期:2024-12-02 出版日期:2025-02-28 发布日期:2025-03-26
  • 通讯作者: 任利,男,硕士,主任医师,从事肝胆胰外科工作。E-mail:renli_xn@163.com
  • 作者简介:刘校伸,男,硕士研究生,从事肝胆胰外科研究。E-mail:lxstgzy@163.com
  • 基金资助:
    青海省科技厅项目(2019-ZJ-7031);2023年度青海省“昆仑英才”行动计划(青人才字[2024]1号);青海科技厅2022年科技计划(青海省包虫病研究重点实验室);青海大学附属医院肝胆外科(包虫病)国家临床重点专科建设项目(青卫健办[2023]125号)

A case of pancreatic cystic echinococcosis misdiagnosed as pancreatic plasma cystadenoma

LIU Xiaoshen1(), WANG Hao1, DU Lei1, FAN Haining1,2, GUO Xinjian3, MA Qianyuan3, REN Li1,2,*()   

  1. 1 Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai, China
    2 Qinghai Key Laboratory of Hydatid Research, Xining 810001, Qinghai, China
    3 Department of Pathology, Qinghai University Hospital, Xining 810001, Qinghai, China
  • Received:2024-08-06 Revised:2024-12-02 Online:2025-02-28 Published:2025-03-26
  • Contact: E-mail: renli_xn@163.com
  • Supported by:
    Project of Science and Technology Department of Qinghai Province(2019-ZJ-7031);2023 Qinghai Province “Kunlun Talent” Action Plan Project (Qinghai Talent Document [2024] No. 1);2022 Science and Technology Project of Qinghai Science and Technology Department (Qinghai Provincial Key Laboratory of Echinococcosis Research);Affiliated Hospital of Qinghai University Hepatobiliary Surgery (Echinococcosis) National Clinical Key Specialty Construction Project(Qing Health Office [2023] No. 125)

摘要:

青海大学附属医院于2023年8月收治一例53岁男性患者。患者自述平时无特殊不适,无肩背部放射痛和腹部疼痛等症状,无牛羊犬等动物密切接触史或长期流行区生活史。入院后查体和实验室检查均无异常。结合患者病史及腹腔脏器三期动态增强CT等影像学检查,初步诊断为胰腺浆液性囊腺瘤。在排除相关手术禁忌症后行腹腔镜下胰体尾切除术,术中发现腹腔内无腹水,肿块位于胰腺体部,边界不清,突出于胰腺表面,大小约4.0 cm × 3.7 cm × 3.0 cm,活动度较差,并与周围肠管黏连。肝脏质地和色泽正常。完整切除胰腺体尾部及病灶后,术中冰冻病理提示为胰体部细粒棘球蚴病。患者术后生命体征平稳,恢复顺利。1个月后复查上腹部CT平扫显示术区较前好转,患者自述术后恢复良好,无明显特殊不适,饮食和睡眠正常,大小便正常,余未见明显异常。

关键词: 细粒棘球蚴病, 胰腺浆液性囊腺瘤, 病例报告, 误诊

Abstract:

The Affiliated Hospital of Qinghai University admitted a 53-year-old male patient in August 2023, who reported that he usually had no special discomfort, no symptoms such as radiating pain in the shoulder and back and abdominal pain, and no history of close contact with animals such as cattle, sheep, and dogs or living in a long-term endemic area. Physical examination and laboratory tests after admission were not abnormal. Combined with the patient’s medical history and imaging examinations such as three-phase dynamic-enhanced CT of the abdominal organs, the preliminary diagnosis was pancreatic plasma cystadenoma. After excluding relevant contraindications to surgery, laparoscopic pancreatic body-tail resection was performed. Intraoperatively, it was found that there was no ascites in the abdominal cavity, and the mass was located in the body of the pancreas, with unclear borders, protruding from the surface of the pancreas, measuring about 4.0 cm × 3.7 cm × 3.0 cm, with poor mobility and adhesion to the surrounding intestinal tract. The liver was normal in texture and color. After complete resection of the caudal part of the pancreatic body and the lesion, intraoperative frozen pathology suggested cystic echinococcosis of the pancreatic body. The patient’s postoperative vital signs were stable and recovery was uneventful. One month later, a follow-up CT scan of the upper abdomen showed that the operated area was better than before, and the patient reported that he had recovered well after the operation, with no obvious special discomfort, normal diet and sleep, normal urination and defecation, and the rest of the patient did not see any obvious abnormality.

Key words: Cystic echinococcosis, Plasma cystadenoma of the pancreas, Case report, Misdiagnosis

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