摘要
目的提高对小儿脾脏血管瘤的认识。方法对我院近年收治的3例小儿脾脏血管瘤患者的临床资料进行分析,并复习有关文献。结果3例均为男性,年龄分别是4个月、6岁和8岁。因左上腹包块或脾肿大就诊。术前经B超和CT检查,2例诊断脾占位性病变,1例拟诊腹膜后肿瘤。2例行脾切除术,1例行脾及胰尾切除。病理诊断分别为幼年性毛细血管瘤、网状血管内皮瘤及丛状血管瘤。3例均治愈,术后平均随访1年,肿瘤无复发或转移。结论小儿脾脏血管瘤少见,有多种病理类型。临床主要表现为腹部包块或脾肿大。内科脾肿大患儿应常规做B超或CT检查,以早期发现脾肿瘤。尽早手术切除脾脏及肿瘤,预后良好。
ObjectiveTo enhance the recognition of splenic hemangioma(SH) in children.Methods3 cases of splenichemangioma in children in our hospital were analyzed retrospectively, and the literatures were reviewed.ResultsAll 3patients were male, who was 4 months、 6 years old and 8 years old respectively. 3 patients came in with abdominal massor palpable spleen. The preoperative diagnosis of 2 cases were splenic space-occupied lesion by B-US and CT, and 1 casewas retroperitional tumor. Splenectomy were performed in 2 cases, and splenectomy plus excision of pancreatic tail in 1case. The pathological types were juvenile capillary hemangioma, retiform hemangioendohelioma and tufted hamangioma.All 3 patients were cured. There were no instance relapse or metastasis of SH during the follow-up of 1year.ConclusionsSH in children is a rare disease, which has different pathological types. The main clinical manifestationsare abdominal mass and splennomegaly. B-US and CT are helpful to early diagnosis of all splennomegaly. Splenectomy shouldbe chosen for SH in children and the prognosis is well.脾脏血管瘤少见,临床医生常认识不足,易被延误诊治。我院近年收治3例脾血管瘤患者,均经手术及病理证实。现报告如下。1临床资料例1,男,4个月,因左上腹包块1个月余,于2001年8月2日入院。家长在给患儿洗澡时,无意中发现其腹部包块,无明显不适。体检:轻度贫血貌。左上腹触及拳头大包块,质韧,光滑,边界清,不活动,无压痛。查血常规血红蛋白84g/L,甲胎蛋白102mg/L。B超示:脾脏内下方、左肾前方不均质性较高回声包块,约7.3cm×6.7cm×5.7cm大小,内见多个不规则的较低回声区及小片状无回声区。CT示:左肾上腺区类圆形肿块,约6.8cm×6.2cm大小,密度不均,可见出血、钙化及囊变。CT值为25.6～61.1Hu。术前考虑腹膜后肿瘤。手术见肿瘤几乎占据整个脾脏,直径约7～8cm,仅存上极少许正常脾组织,包膜完整,质地尚软。因与胰尾紧密粘连,故行脾及胰尾切除术。标本切面呈灰白色,有散在小腔隙。病理诊断:脾脏网状血管内皮瘤,居间型(图1)。术后21个月随访,患儿健康成长,B超检查局部无复发。例2,男,8岁,因左上腹隐痛不适2个月余,于2002年6月19日入院。患儿因“感冒”求诊,体检时发现脾肿大,曾住儿科检查治疗。体检:轻度贫血貌。脾肋下约6cm,质韧,光滑,无压痛。CT示:脾下极低密度占位,约4.5cm×3.8cm。术前考虑脾肿瘤。术中见脾肿大,下极有一肿块,
出处
《罕少疾病杂志》
2003年第5期15-17,共3页
Journal of Rare and Uncommon Diseases
