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| 1 | 胰腺体尾部副神经节瘤1例显示文摘病例女,53岁。1周前无明显诱因出现头晕、乏力伴心悸不适,现症状加重,遂就诊于我院。既往高血压病史5年。入院时患者血压148/90 mmHg(1 mmHg≈0.133 kPa),心率134次/min。近2月来体质量减轻4 kg。实验室检查:血常规、血气分析、凝血功能、肿瘤标记物(CEA、AFP、CA199、CA125)未见明显异常。影像学检查:腹部B超检查胰腺体尾部见一大小约6.9cm×5.2 cm低回声包块,边界清晰,形态不规则,内回声不均匀,包块内见丰富血流信号(图1)。CT平扫见胰腺体尾部一类椭圆形等稍低密度肿块(图2),密度欠均匀,与邻近组织分界较清(图3),大小约7.8 cm×5.3 cm×6.1 cm,增强扫描动脉期见肿块由腹腔干起始段发出的分支血管供血(图4)。 | 袁隆 席华泽 杨晶晶 徐敏 周俊林 | 2023 | 中国临床医学影像杂志2023，34，3： | 0 |
| 2 | Pancreatic paraganglioma with multiple lymph node metastases found by spectral computed tomography: A case report and review of the literature显示文摘BACKGROUND Primary pancreatic paraganglioma is exceedingly rare.Most patients with pancreatic paraganglioma lack a typical clinical presentation,and the tumor is difficult to accurately differentiate from other pancreatic neuroendocrine tumors,making the misdiagnosis rate extremely high.Surgical excision is the primary treatment modality but is considered high risk.Because of its rich vascularity,the tumor easily bleeds during surgery,especially malignant paragangliomas invading large blood vessels.Thus,a thorough preoperative evaluation of the tumor is necessary.Here,we report a primary malignant pancreatic paraganglioma,the second such case in a young patient that was successfully resected surgically.CASE SUMMARY A 26-year-old female patient was admitted to the hospital with unexplained abdominal pain.Dual-layer spectral-detector computed tomography(DLCT)revealed a mixed density mass in the pancreatic body and tail.The patient was transferred to our hospital after previous failed surgical resection at other hospitals.The patient and her family strongly desired surgery.After a thorough preoperative evaluation and adequate preparation,a large mass with the greatest dimension of 8.0 cm was successfully resected.The final pathological diagnosis was malignant paraganglioma.The patient was discharged in good condition 2 wk postoperatively.CONCLUSION The rare malignant pancreatic paraganglioma reported here was difficult to diagnose preoperatively.Early filling of the draining vein may be a crucial diagnostic imaging feature.DLCT can provide more precise information for surgical resection through dual-energy imaging. | Ting Li Rong-Qi Yi Gang Xie Dan-Ni Wang Yi-Tao Ren Kang Li | 2022 | World Journal of Clinical Cases2022，10，31： | 0 |
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