胰腺内辅助脏:没有火可以有烟,没有火可以有烟
Luís Correia Gomes1, Margarida Rajão Saraiva2, António Figueiredo3
1Gastronterology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal.
Revista espanola de enfermedades digestivas
|January 18, 2024
概括
胰腺中的辅助脏可以在成像上模仿神经内分泌瘤 (NETs). 在一个病例中,诊断的挑战导致了手术,而另一个病例被正确地识别为非侵入性手术.
科学领域:
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 胰腺内辅助脏是一种罕见的先天性异常.
- 它们可以在胰腺尾部呈现为固体结节,模仿神经内分泌瘤 (NETs) 等新生瘤.
- 区分辅助脏与胰腺瘤对于适当的管理至关重要.
研究的目的:
- 为了突出胰腺内附属脏的成像和诊断挑战.
- 为了区分辅助脏与胰腺神经内分泌瘤 (NETs).
- 审查诊断方式及其在识别胰腺内附属脏方面的有效性.
主要方法:
- 两名患有胰腺尾部结节的患者的病例介绍.
- 使用了磁共振成像 (MRI),计算机断层扫描 (CT),正子发射断层扫描 (PET-68Ga-DOTANOC),精细针吸收 (FNA) 的内镜超声波 (EUS) 和光束扫描.
- 在一个病例中进行手术切除 (远距离胰腺切除),以确定确诊.
主要成果:
- 案例1:一个69岁的男性的胰腺结节,尽管负生物标志物,但最初怀疑NET,在胰腺切除术后被诊断为辅助脏.
- 案例2:一个77岁的女性的胰腺结节正确地被识别为辅助脏使用EUS和红细胞扫描,避免不必要的手术.
- 辅助脏的成像发现可能与NET的成像结果重叠,需要采用多式联络诊断方法.
结论:
- 胰腺内附属脏可以呈现为高血管结节,构成诊断挑战,并可能导致误诊为NETs.
- 结合先进的成像技术和在某些特定情况下的微创手术,对于准确的诊断至关重要.
- 对于已确认的胰腺内附属脏,非手术治疗是适当的,防止不必要的手术干预.
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