低级别阑尾黏液性肿瘤CT误诊分析  

Cause of CT Misdiagnosis of Low-Grade Appendiceal Mucinous Neoplasm

作　　者：杨巍 何晨冬 YANG Wei;HE Chendong(Department of Radiology,Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China;Department of Radiology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]南京中医药大学附属医院江苏省中医院放射科,南京210029 [2]蚌埠医学院第一附属医院放射科,安徽蚌埠233004

出　　处：《临床误诊误治》2023年第8期35-39,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 分析低级别阑尾黏液性肿瘤(LAMN)的临床及影像资料,总结误诊原因。方法 回顾性分析2020年1月—2023年1月误诊的5例LAMN的临床资料。结果 2例以右下腹阵发性隐痛就诊,1例因常规体检就诊,1例以急性腹胀、腹痛伴恶心、呕吐及停止排便、排气就诊,1例以心悸、胸闷就诊。5例腹部CT检查均误诊。误诊为阑尾黏液囊肿2例,右侧卵巢囊肿1例,腹膜后脉管源性良性病变1例,右侧卵巢浆液性囊腺癌伴腹膜转移1例。误诊时间1~8 d。5例均经手术病理确诊为LAMN。术后均病情好转出院,随访1~16个月,均未见复发。结论 LAMN发病率低,症状无特异性,临床易误诊为阑尾区其他病变或腹膜后囊性病变,对于老年女性患者还需与右侧卵巢病变相鉴别,手术治疗是首选方法。Objective To analyze the clinical and imaging data of low-grade appendiceal mucinous neoplasm(LAMN)and to summarize the causes of misdiagnosis.Methods The clinical data of 5 patients with LAMN misdiagnosed from January 2020 to January 2023 were retrospectively analyzed.Results Two patients presented with paroxysmal dull pain in the right lower abdomen,one presented to the hospital for routine physical examination,one presented with acute abdominal distension and pain accompanied by nausea,vomiting and cessation of defecation and exhaust,and one presented with palpitation and chest distress.All 5 cases were misdiagnosed by abdominal CT,including appendicular mucocele in 2 cases,right ovarian cyst in 1 case,retroperitoneal vascularized benign lesion in 1 case,and right ovarian serous cystadenocarcinoma with peritoneal metastasis in 1 case.Misdiagnosis lasted from 1 to 8 d.All the 5 cases were diagnosed as LAMN by operation and pathology.All patients were discharged from hospital with improved condition after surgery and were followed up for 1 to 16 months without recurrence.Conclusion LAMN has a low incidence and non-specific symptoms,and is more likely to be misdiagnosed clinically as other appendiceal lesions or retroperitoneal cystic lesions.For elderly female patients,LAMN also needs to be differentiated from the right ovarian disease,and surgical treatment is the first choice.

关 键 词：阑尾肿瘤 低级别阑尾黏液性肿瘤 误诊 黏液囊肿 卵巢囊肿 腹膜后脉管源性良性病变 卵巢浆液性囊腺癌 病理学 

分 类 号：R735.36[医药卫生—肿瘤] R445.3[医药卫生—临床医学]