Skip to main content
Erschienen in: Abdominal Radiology 5/2012

01.10.2012

Epidermoid cyst in intrapancreatic accessory spleen: computed tomography findings and clinical manifestation

verfasst von: Shudong Hu, Linxiao zhu, Qi song, Kemin Chen

Erschienen in: Abdominal Radiology | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

This study aims to assess retrospectively the imaging features of computed tomography (CT) and clinical characteristics of epidermoid cyst in intrapancreatic accessory spleen (ECIPAS).

Methods

Seven consecutive patients with pathologically confirmed ECIPAS were included. CT images and clinical data were analyzed. The CT features emphasized included the location, size, calcification, cystic features, surrounding accessory spleen, density, and enhancement of the lesions.

Results

Five patients were male and two were female with a mean age of 43.2 years ranging from 25 to 66 years. Most cases were incidentally detected. All lesions were situated in the pancreatic tail, wherein the mean size was 4.4 cm. The cyst appeared unilocular in four cases and multilocular in three cases. An accessory spleen surrounding the cyst was recognized in all seven cases, and the cystic wall of ECIPAS showed a contrast enhancement similar to that of the spleen during multiphasic scans.

Conclusion

ECIPAS is an extremely rare entity. The diagnosis of an ECIPAS should be considered when enhancing the cystic wall of the lesion in the pancreatic tail similar to that of the spleen during multiphasic scans.
Literatur
1.
Zurück zum Zitat Davidson ED, Campbell WG, Hersh T (1980) Epidermoid splenic cyst occurring in an intrapancreatic accessory spleen. Dig Dis Sci 25(12):964–967CrossRefPubMed Davidson ED, Campbell WG, Hersh T (1980) Epidermoid splenic cyst occurring in an intrapancreatic accessory spleen. Dig Dis Sci 25(12):964–967CrossRefPubMed
2.
Zurück zum Zitat Hwang HS, Lee SS, Kim SC, Seo DW, Kim J (2011) Intrapancreatic accessory spleen: clinicopathologic analysis of 12 cases. Pancreas 40(6):956–965CrossRefPubMed Hwang HS, Lee SS, Kim SC, Seo DW, Kim J (2011) Intrapancreatic accessory spleen: clinicopathologic analysis of 12 cases. Pancreas 40(6):956–965CrossRefPubMed
3.
Zurück zum Zitat Higaki K, Jimi A, Watanabe J, Kusaba A, Kojiro M (1998) Epidermoid cyst of the spleen with CA19-9 or carcinoembryonic antigen productions: report of three cases. Am J Surg Pathol 22(6):704–708CrossRefPubMed Higaki K, Jimi A, Watanabe J, Kusaba A, Kojiro M (1998) Epidermoid cyst of the spleen with CA19-9 or carcinoembryonic antigen productions: report of three cases. Am J Surg Pathol 22(6):704–708CrossRefPubMed
4.
Zurück zum Zitat Morohoshi T, Hamamoto T, Kunimura T, et al. (1991) Epidermoid cyst derived from an accessory spleen in the pancreas. A case report with literature survey. Acta Pathol Jpn 41(12):916–921PubMed Morohoshi T, Hamamoto T, Kunimura T, et al. (1991) Epidermoid cyst derived from an accessory spleen in the pancreas. A case report with literature survey. Acta Pathol Jpn 41(12):916–921PubMed
5.
Zurück zum Zitat Tang X, Tanaka Y, Tsutsumi Y (1994) Epithelial inclusion cysts in an intrapancreatic accessory spleen. Pathol Int 44(8):652–654CrossRefPubMed Tang X, Tanaka Y, Tsutsumi Y (1994) Epithelial inclusion cysts in an intrapancreatic accessory spleen. Pathol Int 44(8):652–654CrossRefPubMed
6.
Zurück zum Zitat Tateyama H, Tada T, Murase T, Fujitake S, Eimoto T (1998) Lymphoepithelial cyst and epidermoid cyst of the accessory spleen in the pancreas. Mod Pathol 11(12):1171–1177PubMed Tateyama H, Tada T, Murase T, Fujitake S, Eimoto T (1998) Lymphoepithelial cyst and epidermoid cyst of the accessory spleen in the pancreas. Mod Pathol 11(12):1171–1177PubMed
7.
Zurück zum Zitat Sasou S, Nakamura S, Inomata M (1999) Epithelial splenic cysts in an intrapancreatic accessory spleen and spleen. Pathol Int 49(12):1078–1083CrossRefPubMed Sasou S, Nakamura S, Inomata M (1999) Epithelial splenic cysts in an intrapancreatic accessory spleen and spleen. Pathol Int 49(12):1078–1083CrossRefPubMed
8.
Zurück zum Zitat Horibe Y, Murakami M, Yamao K, et al. (2001) Epithelial inclusion cyst (epidermoid cyst) formation with epithelioid cell granuloma in an intrapancreatic accessory spleen. Pathol Int 51(1):50–54CrossRefPubMed Horibe Y, Murakami M, Yamao K, et al. (2001) Epithelial inclusion cyst (epidermoid cyst) formation with epithelioid cell granuloma in an intrapancreatic accessory spleen. Pathol Int 51(1):50–54CrossRefPubMed
9.
Zurück zum Zitat Kadota K, Kushida Y, Miyai Y, et al. (2010) Epidermoid cyst in an intrapancreatic accessory spleen: three case reports and review of the literatures. Pathol Oncol Res 16(3):435–442CrossRefPubMed Kadota K, Kushida Y, Miyai Y, et al. (2010) Epidermoid cyst in an intrapancreatic accessory spleen: three case reports and review of the literatures. Pathol Oncol Res 16(3):435–442CrossRefPubMed
10.
Zurück zum Zitat Furukawa H, Kosuge T, Kanai Y, Mukai K (1998) Epidermoid cyst in an intrapancreatic accessory spleen: CT and pathologic findings. AJR Am J Roentgenol 171(1):271CrossRefPubMed Furukawa H, Kosuge T, Kanai Y, Mukai K (1998) Epidermoid cyst in an intrapancreatic accessory spleen: CT and pathologic findings. AJR Am J Roentgenol 171(1):271CrossRefPubMed
11.
Zurück zum Zitat Fink AM, Kulkarni S, Crowley P, Crameri JA (2002) Epidermoid cyst in a pancreatic accessory spleen mimicking an infected abdominal cyst in a child. AJR Am J Roentgenol 179(1):206–208CrossRefPubMed Fink AM, Kulkarni S, Crowley P, Crameri JA (2002) Epidermoid cyst in a pancreatic accessory spleen mimicking an infected abdominal cyst in a child. AJR Am J Roentgenol 179(1):206–208CrossRefPubMed
12.
Zurück zum Zitat Sonomura T, Kataoka S, Chikugo T, et al. (2002) Epidermoid cyst originating from an intrapancreatic accessory spleen. Abdom Imaging 27(5):560–562CrossRefPubMed Sonomura T, Kataoka S, Chikugo T, et al. (2002) Epidermoid cyst originating from an intrapancreatic accessory spleen. Abdom Imaging 27(5):560–562CrossRefPubMed
13.
Zurück zum Zitat Yokomizo H, Hifumi M, Yamane T, et al. (2002) Epidermoid cyst of an accessory spleen at the pancreatic tail: diagnostic value of MRI. Abdom Imaging 27(5):557–559CrossRefPubMed Yokomizo H, Hifumi M, Yamane T, et al. (2002) Epidermoid cyst of an accessory spleen at the pancreatic tail: diagnostic value of MRI. Abdom Imaging 27(5):557–559CrossRefPubMed
14.
Zurück zum Zitat Motosugi U, Yamaguchi H, Ichikawa T, et al. (2010) Epidermoid cyst in intrapancreatic accessory spleen: radiological findings including superparamagnetic iron oxide-enhanced magnetic resonance imaging. J Comput Assist Tomogr 34(2):217–222CrossRefPubMed Motosugi U, Yamaguchi H, Ichikawa T, et al. (2010) Epidermoid cyst in intrapancreatic accessory spleen: radiological findings including superparamagnetic iron oxide-enhanced magnetic resonance imaging. J Comput Assist Tomogr 34(2):217–222CrossRefPubMed
15.
Zurück zum Zitat Nakae Y, Hayakawa T, Kondo T, et al. (1991) Epidermoid cyst occurring in a pancreatic accessory spleen. J Clin Gastroenterol 13(3):362–364CrossRefPubMed Nakae Y, Hayakawa T, Kondo T, et al. (1991) Epidermoid cyst occurring in a pancreatic accessory spleen. J Clin Gastroenterol 13(3):362–364CrossRefPubMed
16.
17.
Zurück zum Zitat Tsutsumi S, Kojima T, Fukai Y, et al. (2000) Epidermoid cyst of an intrapancreatic accessory spleen: a case report. Hepatogastroenterology 47(35):1462–1464PubMed Tsutsumi S, Kojima T, Fukai Y, et al. (2000) Epidermoid cyst of an intrapancreatic accessory spleen: a case report. Hepatogastroenterology 47(35):1462–1464PubMed
18.
Zurück zum Zitat Kanazawa H, Kamiya J, Nagino M, et al. (2004) Epidermoid cyst in an intrapancreatic accessory spleen: a case report. J Hepatobiliary Pancreat Surg 11(1):61–63CrossRefPubMed Kanazawa H, Kamiya J, Nagino M, et al. (2004) Epidermoid cyst in an intrapancreatic accessory spleen: a case report. J Hepatobiliary Pancreat Surg 11(1):61–63CrossRefPubMed
19.
Zurück zum Zitat Ru K, Kalra A, Ucci A (2007) Epidermoid cyst of intrapancreatic accessory spleen. Dig Dis Sci 52(5):1229–1232CrossRefPubMed Ru K, Kalra A, Ucci A (2007) Epidermoid cyst of intrapancreatic accessory spleen. Dig Dis Sci 52(5):1229–1232CrossRefPubMed
20.
Zurück zum Zitat Gleeson FC, Kendrick ML, Chari ST, Zhang L, Lew MJ (2008) Epidermoid accessory splenic cyst masquerading as a pancreatic mucinous cystic neoplasm. Endoscopy 40(Suppl 2):E141–E142CrossRefPubMed Gleeson FC, Kendrick ML, Chari ST, Zhang L, Lew MJ (2008) Epidermoid accessory splenic cyst masquerading as a pancreatic mucinous cystic neoplasm. Endoscopy 40(Suppl 2):E141–E142CrossRefPubMed
21.
Zurück zum Zitat Itano O, Shiraga N, Kouta E, et al. (2008) Epidermoid cyst originating from an intrapancreatic accessory spleen. J Hepatobiliary Pancreat Surg 15(4):436–439CrossRefPubMed Itano O, Shiraga N, Kouta E, et al. (2008) Epidermoid cyst originating from an intrapancreatic accessory spleen. J Hepatobiliary Pancreat Surg 15(4):436–439CrossRefPubMed
22.
Zurück zum Zitat Servais EL, Sarkaria IS, Solomon GJ, Gumpeni P, Lieberman MD (2008) Giant epidermoid cyst within an intrapancreatic accessory spleen mimicking a cystic neoplasm of the pancreas: case report and review of the literature. Pancreas 36(1):98–100CrossRefPubMed Servais EL, Sarkaria IS, Solomon GJ, Gumpeni P, Lieberman MD (2008) Giant epidermoid cyst within an intrapancreatic accessory spleen mimicking a cystic neoplasm of the pancreas: case report and review of the literature. Pancreas 36(1):98–100CrossRefPubMed
23.
Zurück zum Zitat Reiss G, Sickel JZ, See-Tho K, Ramrakhiani S (2009) Intrapancreatic splenic cyst mimicking pancreatic cystic neoplasm diagnosed by EUS-FNA. Gastrointest Endosc 70(3):557–558CrossRefPubMed Reiss G, Sickel JZ, See-Tho K, Ramrakhiani S (2009) Intrapancreatic splenic cyst mimicking pancreatic cystic neoplasm diagnosed by EUS-FNA. Gastrointest Endosc 70(3):557–558CrossRefPubMed
24.
Zurück zum Zitat Zhang Z, Wang JC (2009) An epithelial splenic cyst in an intrapancreatic accessory spleen. A case report JOP 10(6):664–666PubMed Zhang Z, Wang JC (2009) An epithelial splenic cyst in an intrapancreatic accessory spleen. A case report JOP 10(6):664–666PubMed
25.
Zurück zum Zitat Itano O, Chiba N, Wada T, et al. (2010) Laparoscopic resection of an epidermoid cyst originating from an intrapancreatic accessory spleen: report of a case. Surg Today 40(1):72–75CrossRefPubMed Itano O, Chiba N, Wada T, et al. (2010) Laparoscopic resection of an epidermoid cyst originating from an intrapancreatic accessory spleen: report of a case. Surg Today 40(1):72–75CrossRefPubMed
26.
Zurück zum Zitat Khashab MA, Canto ML, Singh VK, et al. (2011) Endosonographic and elastographic features of a rare epidermoid cyst of an intrapancreatic accessory spleen. Endoscopy 43(Suppl 2):E193–E194CrossRefPubMed Khashab MA, Canto ML, Singh VK, et al. (2011) Endosonographic and elastographic features of a rare epidermoid cyst of an intrapancreatic accessory spleen. Endoscopy 43(Suppl 2):E193–E194CrossRefPubMed
27.
Zurück zum Zitat Ough YD, Nash HR, Wood DA (1981) Mesothelial cysts of the spleen with squamous metaplasia. Am J Clin Pathol 76(5):666–669CrossRefPubMed Ough YD, Nash HR, Wood DA (1981) Mesothelial cysts of the spleen with squamous metaplasia. Am J Clin Pathol 76(5):666–669CrossRefPubMed
28.
Zurück zum Zitat Bürrig KF (1988) Epithelial (true) splenic cysts. Pathogenesis of the mesothelial and so-called epidermoid cyst of the spleen. Am J Surg Pathol 12(4):275–281CrossRefPubMed Bürrig KF (1988) Epithelial (true) splenic cysts. Pathogenesis of the mesothelial and so-called epidermoid cyst of the spleen. Am J Surg Pathol 12(4):275–281CrossRefPubMed
29.
Zurück zum Zitat Lifschitz-Mercer B, Open M, Kushnir I, Czernobilsky B (1994) Epidermoid cyst of the spleen: a cytokeratin profile with comparison to other squamous epithelia. Virchows Arch 424(2):213–216CrossRefPubMed Lifschitz-Mercer B, Open M, Kushnir I, Czernobilsky B (1994) Epidermoid cyst of the spleen: a cytokeratin profile with comparison to other squamous epithelia. Virchows Arch 424(2):213–216CrossRefPubMed
Metadaten
Titel
Epidermoid cyst in intrapancreatic accessory spleen: computed tomography findings and clinical manifestation
verfasst von
Shudong Hu
Linxiao zhu
Qi song
Kemin Chen
Publikationsdatum
01.10.2012
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 5/2012
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-012-9851-0

Weitere Artikel der Ausgabe 5/2012

Abdominal Radiology 5/2012 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.