{"id":3706,"date":"2018-02-26T09:39:47","date_gmt":"2018-02-26T09:39:47","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/esplenose-pancreatica\/"},"modified":"2022-05-27T00:26:14","modified_gmt":"2022-05-27T00:26:14","slug":"esplenose-pancreatica","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/esplenose-pancreatica\/","title":{"rendered":"Esplenose Pancre\u00e1tica"},"content":{"rendered":"

Paciente do sexo feminino, 38 anos, foi submetida \u00e0 RNM de abd\u00f4men para a avalia\u00e7\u00e3o de cisto renal complexo, realizando diagn\u00f3stico incidental de um n\u00f3dulo hipervascularizado, medindo aproximadamente 20 mm, localizado na cauda do p\u00e2ncreas. A paciente apresentava obesidade, IMC de 40, Diabetes Mellitus, Hipertens\u00e3o Arterial e Hipercolesterolemia.<\/p>\n

\"esplenose1\"<\/a><\/p>\n

Para investigar a les\u00e3o pancre\u00e1tica, foi optado por realizar ecoendoscopia\u00a0 com\u00a0 pun\u00e7\u00e3o aspirativa do n\u00f3dulo.<\/p>\n

\"esplenose2\"<\/a> \"esplenose3\"<\/a><\/p>\n

A ecoendoscopia demonstrou uma les\u00e3o na cauda do p\u00e2ncreas, hipoec\u00f3ica, regular, com ecotextura semelhante ao ba\u00e7o. A les\u00e3o foi puncionada com agulha de 22 G.<\/p>\n

\"esplenose4\"<\/a>

imagem ilustrativa<\/p><\/div>\n

O resultado da avalia\u00e7\u00e3o histocitol\u00f3gica revelou presen\u00e7a de corpo de Malpighi, compat\u00edvel com tecido espl\u00eanico e confirmando o diagn\u00f3stico de esplenose pancre\u00e1tica.<\/p>\n

 <\/p>\n

Revis\u00e3o<\/strong><\/p>\n

A esplenose abdominal \u00e9 o transplante espont\u00e2neo de tecido espl\u00eanico para locais n\u00e3o usuais. Esta situa\u00e7\u00e3o ocorre geralmente ap\u00f3s trauma ou cirurgia. Outra causa poss\u00edvel \u00e9 a falha na coalesc\u00eancia durante a migra\u00e7\u00e3o mesenquimal das c\u00e9lulas espl\u00eanicas.\u00a0\u00a0 A esplenose pancre\u00e1tica \u00e9 descoberta na maioria das vezes incidentalmente e n\u00e3o necessita ressec\u00e7\u00e3o cir\u00fargica se o diagn\u00f3stico for acurado. Entretanto, a esplenose pancre\u00e1tica pode ser confundida com um tumor neuroend\u00f3crino pancre\u00e1tico n\u00e3o funcionante, j\u00e1 que as duas les\u00f5es tem\u00a0 caracter\u00edstica hipervasculares semelhantes \u00e0 avalia\u00e7\u00e3o pela tomografia ou RNM. Devido \u00e0 isso, o diagn\u00f3stico preciso \u00e9 crucial, j\u00e1 que a esplenose n\u00e3o requer tratamento cir\u00fargico.<\/p>\n

Os achados ecoendosc\u00f3picos da esplenose pancre\u00e1tica podem ser desafiadores. Mesmo o achado mais frequente de les\u00e3o homog\u00eanea, hipoec\u00f3ica e bem circunscrita requer a pun\u00e7\u00e3o aspirativa para diferenci\u00e1-la\u00a0 de um tumor neuroend\u00f3crino.<\/p>\n

\u00a0<\/strong><\/p>\n

REFER\u00caNCIAS.<\/strong><\/p>\n

    \n
  1. Ardengh JC, de Paulo GA, Ferrari AP. EUS-guided FNA in the diagnosis of pancreatic neuroendocrine tumors before surgery. Gastrointest Endosc. 2004;60:378-84<\/li>\n
  2. La\u00fcffer JM, Baer HU, Maurer CA, Wagner M, Zimmermann A, B\u00fcchler MW. Intrapancreatic accessory spleen. A rare cause of a pancreatic mass. Int J Pancreatol. 1999;25:65-8<\/li>\n
  3. Fiamingo P, Veroux M, Da Rold A, Guerriero S, Pariset S, Buffone A, Tedeschi U. A rare diagnosis for a pancreatic mass: splenosis. J Gastrointest Surg. 2004;8:915-6.<\/li>\n
  4. Fremont RD, Rice TW. Splenosis: a review. South Med J. 2007;100:589-93<\/li>\n<\/ol>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

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