Splenic epidermoid cyst

Splenic epidermoid cyst is a rare cystic disease affecting the spleen. We report a young male who presented with a painless abdominal lump. Ultrasonography and CT scan of abdomen showed a huge cystic lesion of obscure origin. At laparotomy a huge cyst was found to be arising from the superior pole of the spleen, and its removal necessitated splenectomy. Histopathological findings were consistent with splenic epidermoid cyst. The aetiopathology and different treatment modalities of splenic cysts are discussed. Key words: splenic cyst, epidermoid cyst, pseudocyst, splenectomy.     

腹腔镜部分脾切除治疗巨大脾表皮样囊肿一例

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We report a rare case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique reduces hospital stay and the patient recovery rapidly.     

Concomitant bilateral testicular epidermoid cysts

Epidermoid cyst of the testis is a rare benign germ cell tumor, comprising 1-2% of all resected benign testicular masses. Approximately 300 cases have been reported to date. Unilateral involvement has often been reported in the English literature. However, bilateral occurrence is very rare and to the best of our knowledge, there are only 3 previous reports of bilateral testicular epidermoid cysts. The fact that they are completely benign makes them amenable to treatment by local excision, thereby saving patient from orchidectomy. Recognition of their characteristic ultrasonographic features is very important to avoid unnecessary intervention. We present here, a case of bilateral epidermoid cyst in which characteristic ultrasound (US) findings allowed testis-sparing enucleation instead of radical orchiectomy.     

Laparoscopic partial splenectomy for large splenic epidermoid cyst

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We reported a case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique induces a reduced hospital stay and a more rapid recovery.     

Laparoscopic partial splenectomy for large splenic epidermoid cyst

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We reported a case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique induces a reduced hospital stay and a more rapid recovery.

     

颅骨板障表皮样囊肿的影像诊断

目的探讨颅骨板障表皮样囊肿的影像学表现,并与病理相对照。资料与方法回顾性分析6例经手术病理证实的颅骨板障表皮样囊肿影像学资料及病理资料。3例平片,4例CT,6例MR,6例MR均行增强扫描。结果病灶位于枕骨3例,颞骨2例,额骨1例;平片病变主要表现为边界清楚的骨质破坏区;CT上显示病灶位于板障,内外板呈膨胀性骨质改变,骨质破坏以内板为著,囊肿呈等低密度,内可见更低密度脂质成分;MRI T1WI主要表现为稍低信号伴有不均匀高信号,T2WI则以高信号为主伴有片状低信号,增强扫描后囊肿不强化,病变一侧的硬脑膜保持完整且明显强化。6例患者均经手术及病理证实为颅骨板障来源表皮样囊肿。结论颅骨板障表皮样囊肿的影像学表现有一定的特点,CT及MR对病变的定位、定性诊断更有帮助。     

桥小脑角表皮样囊肿的磁共振影像表现及其扫描技术分析

目的分析桥小脑角表皮样囊肿的磁共振成像(MRI)表现,探讨磁共振(MR)扫描技术在桥小脑角表皮样囊肿诊断中的价值。方法回顾性分析12例桥小脑角表皮样囊肿的MR扫描技术及MRI表现。结果 12例中1例T1WI呈高信号,其余T1WI呈低信号。所有病例T2WI均呈高信号,稍高于脑脊液。9例FLAIR囊内见不同数量的絮状稍高信号影,其中有2例仅在边缘出现少量絮状等高信号影。DWI均表现为明显高信号,信号不均匀。结论桥小脑角表皮样囊肿MRI表现具有特征性,MRI对本病的诊断与鉴别诊断具有价值,联合应用DWI和T2 FLAIR有利于桥小脑角皮样囊肿的诊断。     

表皮囊肿癌变临床病理特点及文献复习

目的:研究和探讨表皮囊肿及其癌变的发病机理、临床病理特点、诊断和鉴别诊断及治疗。方法:对2例表皮囊肿癌变进行光镜观察,并复习相关文献。结果:2例表皮囊肿的囊壁内衬上皮出现异常增生,增生的细胞具有明显异型性,核深染,可见病理性核分裂像,呈典型鳞状细胞癌结构,并向周围组织浸润性生长。结论:表皮囊肿是一种常见的良性病变,极少癌变;其诊断主要依靠组织病理学;主要的治疗方法是手术切除,辅以局部放射治疗和(或)化疗。     

颅内表皮样囊肿MRI诊断15例

目的 分析颅内表皮样囊肿的MRI表现.方法 收集经手术病理证实的颅内表皮样囊肿15例,重点分析肿瘤的好发部位、大小形态及MRI扫描与增强扫描的信号特点.结果 在本组病例中,桥小脑角区8例,鞍旁2例,斜坡区2例,枕骨1例,侧脑室三角部、第四脑室各1例.肿瘤在T1加权像上呈不均匀低信号,T2加权像、FLAIR图像上呈不均匀高信号,所有病例均行增强扫描,肿瘤均无强化.结论 典型的颅内表皮样囊肿的MRI表现具有特征性,MRI检查可以作出准确诊断,并能与其他类似的颅内囊性病变相鉴别.     

二维灰阶超声联合超声造影对睾丸表皮样囊肿的诊断价值

探讨二维灰阶超声联合超声造影(CEUS)对睾丸表皮样囊肿的诊断价值。方法 选择2009年7月至2015年12月空军军医大学第一附属医院收治的经手术组织病理证实为睾丸表皮样囊肿的47例患者,回顾性分析患者检查的声像图资料,分析超声术前诊断睾丸表皮样囊肿的准确度。结果 二维超声术前诊断睾丸表皮样囊肿准确度为85.71%(42/49),二维灰阶联合CEUS诊断准确度为93.88%(46/49)。结论 二维灰阶联合CEUS对睾丸表皮样囊肿诊断价值较高。     

Extratesticular epidermoid cyst mimicking enlarged testis

Epidermoid cysts are benign simple epithelial tumors usually appearing as hypoechoic lesions with scattered echogenic reflectors on sonography. Herein, we present a 53-year-old man with an extratesticular epidermoid cyst in the right scrotum which shows confusing sonographic findings, normal-appearing echogenicity of the lesion and atrophied testis, which lead to a diagnostic dilemma. With a variety of sonographic presentations in extratesticular epidermoid cysts, magnetic resonance (MR) imaging could play a complementary role in difficult cases.     

颅内表皮样囊肿的临床特征及显微手术治疗

目的对1994～2004年完成的颅内表皮样囊肿显微外科手术进行总结,为此种疾病今后的诊断和治疗提供有益的参考。方法对本院12例颅内表皮样囊肿患者,先行CT和MRI检查,随后在全麻下进行显微外科的手术切除。以电凝切开囊膜,将囊内实质逐步摘除,然后沿边界细心分离,逐一电凝并切断血供及粘连,彻底切除囊肿。对于粘连过于紧密的部位,宁可残余少量组织,以免出现术后严重的并发症。并在术后对患者的检查资料进行总结,对病变组织进行影像学和病理学分析。结果12例颅内表皮样囊肿患者中,8例位于桥小脑角,颅底斜坡2例,鞍区1例,脑室1例。手术切除的囊肿组织,75％(9／12例)呈不规则形态。CT平扫83．33％(10／12例)为均匀低密度,且造影后90％(9／10例)未发生强化MRI T1呈均匀低信号,与脑脊液基本类似或略高于脑脊液,T2呈均匀高信号,占75％(9／12例)。周围脑组织未发现有水肿现象;但是当瘤体较大时会引起比较明显的占位效应,占66．67％(8／12例)。结论颅内表皮样囊肿在CT和MRI检查中可见有特征性表现,为手术提供较为准确的术前诊断,术中观察和术后的病理切片均得以证实。经过显微外科手术,基本可以完全切除囊肿组织,达到较好的治疗效果。     

磁共振弥散加权成像对表皮样囊肿鉴别诊断的帮助

目的：评价弥散加权成像在诊断表皮样囊肿中的作用。方法：对17例经手术病理证实的表皮样囊肿和6例蛛网膜囊肿行常规MRI扫描和弥散加权成像。结果：表皮样囊肿在弥散加权为高信号,蛛网膜囊肿为低信号。结论：弥散加权成像对鉴别表皮样囊肿有较高的应用价值。     

Aplasia of the right lung and calcifying epithelioma in association with Goldenhar's syndrome

A case of Goldenhar''s syndrome (oculoauriculovertebral dysplasia) with the rare association of aplasia of one lung is presented with a discussion of the clinical findings and the aetiology. The major abnormalities, pulmonary, renal and the undergrowth of the jaw were all right-sided, confirming previous reports. This child developed a calcifying epithelioma and this is cited as support for the theory of the origin of these lesions from epidermoid cysts.     

表皮样囊肿声像图特点与病理改变的关系

目的探讨表皮样囊肿的超声成像特点与病理组织学的关系。方法回顾分析21例经手术病理检查证实的表皮样囊肿的不同超声图像特征及其与病理改变的关系。结果21例表皮样囊肿患者基本具有3种超声特征表现:(1)肿块内部回声均质型(17例):病理改变为囊肿内部角质上皮相对偏少,呈层状分布;(2)肿块内部回声不均质型(3例):病理显示囊壁有破裂,囊内角质上皮、坏死鳞状上皮紊乱分布,并有纤维化、钙化等多种表现;(3)肿块内部回声呈强弱相间的螺纹征型(1例):病理显示呈同心圆层状分布的致密角质层和坏死鳞状上皮细胞。结论表皮样囊肿具有较典型的超声表现,其声像图特征与不同病理组织学改变相对应。内部回声均质是表皮样囊肿最常见的声像图特征。     

浅表组织表皮样囊肿的声像图分析

目的分析全身浅表组织表皮样囊肿的声像图特点。方法回顾性分析36例浅表器官表皮样囊肿的患者临床资料,对其形态、大小、位置、内部回声、边界、包膜、后方回声、有无感染及血流情况进行分析。结果 36例中肿块位置均位于皮下,有包膜,边界清,内部回声不均,成细密点状回声,后方回声略增强,肿物内部无血流信号。病理结果显示肿物切面为囊性,壁较薄,囊内表面光滑,囊内为灰白色豆渣样物。结论表皮样囊肿声像图具有一定特征性,高频超声具有较高的诊断价值。     

颅底中央区巨大表皮样囊肿显微外科治疗

目的:探讨颅底中央区巨大表皮样囊肿显微外科治疗的临床疗效.方法:回顾性分析显微外科手术治疗颅底中央区巨大表皮样囊肿36例的临床特点和手术体会.结果:36例颅底中央区巨大表皮样囊肿中,手术全切除32例,次全切除4例,颅神经损伤或症状加重13例,无手术死亡.结论:根据表皮样囊肿累及的部位,选择好手术入路和运用好显微外科技术可提高手术的全切率,降低并发症.     

Splenic epidermoid cysts presenting as an acute abdomen

Two patients with splenic epidermoid cysts who presented as acute abdominal emergencies are reported.     

磁共振扩散加权成像在临床脑肿瘤中的应用分析

目的分析磁共振扩散加权成像(DWI)在脑肿瘤临床诊断中的应用价值。方法对40例脑脓肿、52例胶质瘤、58例转移瘤、28例表皮样囊肿、52例蛛网膜囊肿进行常规MR、DWI成像、表观扩散系数(ADC)测量和增强MR检查,分析其影像学表现。结果脑脓肿、胶质瘤和转移瘤全部强化,表现为环状或花环状强化;表皮样囊肿、蛛网膜囊肿病例不强化。DWI上32例脑脓肿和28例表皮样囊肿呈高信号;52例蛛网膜囊肿均为低信号;110例脑肿瘤患者中,10例胶质瘤呈高信号,26例呈混杂信号,其中20例为胶质瘤,6例转移瘤,其余均为低信号。结论 MR扩散加权成像及增强磁共振在颅内囊性病变的定性诊断中意义重大。     

口腔颌面部软组织发育性囊肿的诊断与治疗——附94例临床分析

<正> 口腔颌面部囊肿,按Lucas分类为骨内囊肿(包括面裂囊肿、牙源性囊肿和非上皮性骨囊肿)和软组织囊肿(包括潴留囊肿和发育性囊肿)。本文只讨论软组织发育性囊肿,即鼻唇囊肿、龈囊肿、甲状舌管囊肿、鳃裂囊肿、畸胎样囊肿、皮样和表皮样囊肿的临床诊断和治疗。