Gastrointestinal sistem kaynaklı konjenital nadir görülen kistik lezyonların histopatolojik değerlendirmesi

Yıl 2019, Cilt: 12 Sayı: 3, 509 - 516, 30.09.2019

Saadet Alan

https://doi.org/10.31362/patd.550218

Öz

Amaç: Gastrointestinal sistem kaynaklı konjenital kistler
oldukça nadir görülmektedir. Bu grupta mezenterik- omental kistler, enterik duplikasyon
kistleri, meckel divertikülü/ omfalomezenterik duktus kistinden oluşmaktadır. Etyopatogenez,
histopatoloji ve klinik özellikleri önemli ölçüde farklılık göstermektedir. Neoplastik
kitleler ile ayırt etmede tanı zorluğuna neden olmaktadırlar. Bu çalışmada intrabdominal
gastrointestinal sistem kaynaklı konjenital benign kistik lezyonların klinik, histopatolojik
özellikleri ve ayırıcı tanıları birlikte incelenmiştir.

Gereç ve Yöntem: Tıbbi Patoloji  Anabilim Dalı arşivi taranarak mide, ince-kalın
barsak, mezenterik-omentumdan köken alan intrabdominal konjenital kistik
kitleler çalışmaya alınmıştır.

Bulgular:  Nonneoplastik kistik 55 olgu retrospektif
olarak incelendi.  Yaş, cinsiyet, klinik
semptom, yerleşim yeri, histopatolojik bulgularına göre olgular
değerlendirildi. En sık meckel divertikülü/ omfalomezenterik duktus kisti (n:34)
mevcuttu. Daha sonra olguların görülme sıklığı sırasıyla; mezenterik-omental
kistleri (n:15) ve duplikasyon kistlerine (n:6) rastlandı. En sık görülen bulgu
abdominal kitle ve ağrıydı.

Sonuç: Kistlerin kökeni ne olursa olsun spesifik
tiplendirme, lezyonların histopatolojik olarak değerlendirmesiyle ( epitele
sahip olup olmayışı, epitelin tipi) konmaktadır. Gastrointestinal sistem
yerleşimli kistler ile ilgili en önemli sorun, bazen bu kistlerin neoplastik
nitelik taşıyan kitlelerden veya parazite bağlı kistlerden ayırt
edilememesidir. Fizik muayenede düzgün sınırlı kitle palpe edilen ve
görüntüleme yöntemleriyle intraabdominal kistik kitle saptanan, karın ağrısı
ile başvuran hastalarda ayırıcı tanıda farklı gelişimsel nitelikler taşıyan
kistik kitleler göz önünde bulundurulmalıdır.

Anahtar Kelimeler

Mezenterik kist, enterik duplikasyon kistleri, meckel divertikülü

Histopathological evaluation of congenital rare cystic lesions of gastrointestinal tract.

Öz

Purpose:
Congenital cysts originating from the gastrointestinal tract are very rare. In
this group, mesenteric-omental cysts, enteric duplication cysts, meckel
diverticulum / omphalomesenteric duct cyst. The etiopathogenesis,
histopathology and clinical features differ significantly. They cause
diagnostic difficulties in differentiating with neoplastic masses. In this
study, the clinical, histopathological and differential diagnoses of the
congenital benign cystic lesions of the intrabdominal gastrointestinal tract
were investigated.

Materials
and Methods: The archives of the Department of Medical Pathology
were reviewed and intrabdominal congenital cystic masses originating from the
stomach, small-large intestine and mesenteric-omentum were included in the
study.

Result:
Nonneoplastic cystic cases were retrospectively evaluated. Patients were evaluated
according to age, gender, clinical symptoms, location and histopathological
findings. The most common meckel diverticulum / omphalomesenteric duct cyst
(n:34) was present. Then, the incidence of the cases were as follows;
mesenteric-omental cysts (n:15) and duplication cysts (n:6). The most common
finding was abdominal mass and pain.

Conclusion:
Specifically, regardless of the origin of cysts, specific typing is indicated
by histopathological evaluation of lesions (epithelium, type of epithelium).
The most important problem with cysts located in the gastrointestinal tract is
that these cysts cannot be differentiated from neoplastic masses or parasites.
In physical examination, cystic masses with different developmental
characteristics should be considered in the differential diagnosis of patients
with abdominal pain and intraabdominal cystic mass with palpated mass.

 

Anahtar Kelimeler

Mesenteric cysts, duplication cysts, meckel diverticulum

Kaynakça

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