胰腺淋巴上皮囊肿的临床诊治特点

  目的  分析胰腺淋巴上皮囊肿(pancreatic lymphoepithelial cyst，PLEC)的临床诊治特点，为提高其诊疗水平提供借鉴和参考。  方法  回顾性分析2015年1月至2019年12月在北京协和医院基本外科行手术治疗并最终确诊为PLEC的患者临床资料，分析其临床表现、影像学特征及治疗效果。  结果  共7例患者确诊为PLEC，年龄31~65岁，其中男性4例，女性3例；5例患者肿物位于胰体尾部，1例位于胰颈部，1例位于胰头部；2例患者血清CA19-9水平增高；3例患者术后出现胰瘘导致腹腔引流管拔除延迟；1例随访中出现体重下降。  结论  PLEC是一种罕见的胰腺囊性病变，临床表现不典型，术前诊断较为困难，手术可完整切除，预后良好；无症状者可考虑保守治疗和随访观察。

Diagnosis and Treatment of Pancreatic Lymphoepithelial Cyst

  Objective  The aim of this study was to investigate the clinical characteristics of pancreatic lymphoepithelial cyst (PLEC), a rare cystic lesion in the pancreas.  Methods  The clinical data of patients with PLEC who underwent pancreatectomy from 2016 to 2019 in Peking Union Medical College Hospital were analyzed retrospectively. The clinical presentations and imaging features were summarized.  Results  A total of 7 patients with PLEC were included in this study, including 4 males and 3 females. The average age was 49 years old. One patient suffered from abdominal distension and the other 6 showed no symptom. A unique round lesion in the pancreas was found in all cases with cross-section scanning. Five lesions were located in pancreatic body and tail, and two were found in pancreatic head and neck. Serum CA19-9 levels were above normal upper limit in two patients. 18F-FDG PET/CT was performed in two patients, which showed high intake in part of the cyst wall in one patient. The complications with pancreatectomy in this cohort were pancreatic fistulae in 3 patients and low body weight in one patient. No sign of recurrence was found during a median follow-up of 17 months.  Conclusions  PLEC is a rare benign cystic lesion in the pancreas. The preoperative differential diagnosis was quite difficult with imaging examination and clinical presentations. A comprehensive diagnosis strategy with endoscopic ultrasonography aspiration biopsy may help for preoperative diagnosis. Asymptomatic patients can be considered for observation and follow-up.