Basit ve epidermoid dalak kisti

Özet

Epidermoid dalak kistleri doğuştan kabul edilir; çoğu asemptomatiktir ve görüntülemede tesadüfen saptanabilir. Kontrastlı BT'de epidermoid dalak kisti düşük dansiteli, ince duvarlı ve tek odacıklı bir lezyon olarak görülebilir; solid bileşen bulunup bulunmadığı değerlendirilebilir. Epidermoid kistin histolojik epitel yapısı yalnız BT ile kanıtlanamaz; görüntüleme onu benign nonparaziter kist olarak düşündürür. Kanama, enfeksiyon veya rüptür gelişirse basit kist görünümü değişebilir ve bu komplikasyonların atlanması klinik önem taşır.

Faz ve pencere

Kontrastsız tanısal

Kontrastlı BT, lezyonun homojen sıvı dansiteli içerik, ince duvar ve kontrastlanmayan düzlemsel yapılar açısından karakterize edilmesini sağlar; solid komponentlerin ekarte edilmesi için kontrast fazının değerlendirilmesi gerekir.

Önerilen pencereler: Batın (G 400 / M 50).

BT bulguları

• Dalakta iyi sınırlı, oval kistik lezyon
• Tek odacıklı ve homojen sıvı dansiteli içerik
• İnce, düzgün veya BT'de seçilemeyen duvar
• İç septa, mural nodül ya da solid yumuşak doku bileşeni bulunmaması
• Duvar kalsifikasyonu bazı epidermoid kistlerde görülebilir
• Kanama veya protein içeriği artışı varsa iç atenüasyon basit sıvıdan yüksek olabilir
• Büyüyen kistte komşu mide, böbrek veya diyaframda bası ve dalak konturunda bombeleşme

Normalde

Normal dalakta parankim kesintisiz ve homojendir; parankim içinde sıvı dansiteli yuvarlak boşluk ya da duvar kalsifikasyonu görülmez. Kisti komşu mide fundusu ve sol böbrekten ayıran dalak kapsülünü izle; içerik homojenliğini ve lezyonun dalak dış konturuna yaptığı basıyı kıyasla.

Ayırıcı tanı

Dalak psödokisti

travma veya hematom öyküsü ve epitelyal döşeme olmaması ile ilişkilidir.

Kistik ekinokokkozis

kız kistler, ayrılmış membran veya çok odacıklı ana kist görünümü ayırır.

Kistik lenfatik malformasyon

dalakta görülebilir; tek veya çok kistik olabilir ve ince septaları hafif ya da orta derecede kontrastlanabilir.

Dalak apsesi, kistik dalak lezyonlarının ayırıcı tanısında yer alabilir.

Kistik nekrotik tümör

kontrastlanan mural nodül veya periferik solid doku araştırılır.

Tuzaklar

• Kontrastsız seride içeriğin homojen düşük atenüasyonda olması kontrastlanmama kanıtı değildir; solid bileşen kuşkusu varsa kontrastlı karakterizasyon gerekir.
• Epidermoid kist ile psödokistin duvar görünümü örtüşebilir; epitel varlığı görüntüyle kesinleştirilemez.
• Yüksek atenüasyonlu içerik otomatik olarak solid tümör sayılmaz; kanama veya yoğun proteinli sıvı içeriği olabilir.
• Kist çevresindeki ince kalsifikasyonu kız vezikül sanmamak için kalsifikasyonun duvar boyunca uzanıp uzanmadığını izle.

Kendini dene

1. Tesadüfen saptanan dalak lezyonu düzgün sınırlı, homojen sıvı dansiteli ve tek boşluklu; membran veya nodül yok. En olası tanı?

   • Basit nonparaziter dalak kisti
   • Hidatik kist
   • Dalak apsesi
   • Kistik metastaz
   Cevabı göster

   Basit nonparaziter dalak kisti. Görüntüleme tek başına epitel döşemesini kanıtlamaz; bu nedenle tanı basit nonparaziter dalak kisti olarak verilir. Hidatik kistte kız kist veya membran, apsede inflamatuvar içerik, kistik tümörde ise kontrastlanan solid bileşen aranır.

2. Dalak içinde basit sıvı atenüasyonlu kistin ayrımında en çok hangi özellik şüphe uyandırır?

   • Mural yumuşak doku nodülü
   • Düzgün dış kontur
   • Homojen sıvı içeriği
   • İnce seçilemeyen duvar
   Cevabı göster

   Mural yumuşak doku nodülü. Mural nodül basit kist görünümünü bozar ve kontrastlı karakterizasyon gerektirir; diğer seçenekler tipik benign kist morfolojisine uyar.

İlgili konular

• Dalak psödokisti
• Dalak kistik ekinokokkozisi

Kaynaklar

Bu sayfadaki 34 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 9 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Obstructive Pyelonephritis Secondary to Ureteral Compression by an Intra‐Abdominal Desmoid Tumor in Familial Adenomatous Polyposis: A Case Reportpmc.ncbi.nlm.nih.gov
2. Recurrent splenic epidermoid cyst in a young adult: A case report and literature reviewpmc.ncbi.nlm.nih.gov
3. Peritoneal Inclusion Cyst in an Unusual Location in a “Virgin” Abdomen: A Diagnostic Dilemma Expanding the Clinical Spectrumpmc.ncbi.nlm.nih.gov
4. Laparoscopic Partial Splenectomy for a Giant Congenital Splenic Cyst in a Child: Case Report and Focused Literature Reviewpmc.ncbi.nlm.nih.gov
5. Case Report: Primary splenic hydatid cystpmc.ncbi.nlm.nih.gov
6. A case of ruptured splenic cyst with elevated serum levels of CEA treated by laparoscopic unroofing.pubmed.ncbi.nlm.nih.gov
7. Obstructive Pyelonephritis Secondary to Ureteral Compression by an Intra-Abdominal Desmoid Tumor in Familial Adenomatous Polyposis: A Case Report.pubmed.ncbi.nlm.nih.gov
8. Fetal MRI: abdominal cystic lesions.pubmed.ncbi.nlm.nih.gov
9. A Comprehensive Review of Splenic Cysts: Case Reports and Clinical Insight.pubmed.ncbi.nlm.nih.gov
10. 불분명한 소아 복부 종괴: 영상 기반 진단 접근법.pubmed.ncbi.nlm.nih.gov
11. Peritoneal Inclusion Cyst in an Unusual Location in a "Virgin" Abdomen: A Diagnostic Dilemma Expanding the Clinical Spectrum.pubmed.ncbi.nlm.nih.gov
12. Clinical, Radiological, and Endoscopic Features of Pancreatic Pseudocyst and Walled-Off Necrosis: How to Diagnose and How to Drain Them.pubmed.ncbi.nlm.nih.gov
13. Special Issue: EACR 2026 Congress: Innovative Cancer Science, 8-11 June 2026.pubmed.ncbi.nlm.nih.gov
14. Pathology of Aging in NOD scid gamma Female Mice.pubmed.ncbi.nlm.nih.gov
15. ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes.pubmed.ncbi.nlm.nih.gov
16. Severe Splenic Rupture After Minor Blunt Trauma in a Patient With an Epidermoid Splenic Cyst: A Case Report.pubmed.ncbi.nlm.nih.gov
17. Upper gastrointestinal hemorrhage due to splenic artery pseudoaneurysm combined with pancreatic pseudocyst recurrence: A case report.pubmed.ncbi.nlm.nih.gov
18. Our Experience in the Management of Splenic Arterial Thrombosis.pubmed.ncbi.nlm.nih.gov
19. The Spectrum of Solitary Benign Splenic Lesions-Imaging Clues for a Noninvasive Diagnosis.pubmed.ncbi.nlm.nih.gov
20. Tips and Tricks in Thoracic Radiology for Beginners: A Findings-Based Approach.pubmed.ncbi.nlm.nih.gov
21. Imaging insights into pediatric liver masses: A comprehensive minireview for hepatology practice.pubmed.ncbi.nlm.nih.gov
22. Imaging of renal pseudotumors in children: a comprehensive review.pubmed.ncbi.nlm.nih.gov
23. Comparison of Virtual Non-Contrast Images Generated by Spectral Detector Computed Tomography and Conventional Computed Tomography Images of Histologically Confirmed Hepatic Pathologies in 28 Dogs.pubmed.ncbi.nlm.nih.gov
24. Common and Uncommon Splenic Lesions: A Review.pubmed.ncbi.nlm.nih.gov
25. A case series of radiologically misdiagnosed visceral lymphatic malformations.pubmed.ncbi.nlm.nih.gov
26. Splenic pathologies: A pictorial review of common, wandering, twisting and rare presentations.pubmed.ncbi.nlm.nih.gov
27. Left subphrenic lymphocele after total gastrectomy.pubmed.ncbi.nlm.nih.gov
28. Incidental Focal Spleen Lesions: Integrated Imaging and Pattern Recognition Approach to the Differential Diagnosis.pubmed.ncbi.nlm.nih.gov
29. Navigating Ovarian-Adnexal Reporting and Data System Magnetic Resonance Imaging (O-RADS MRI): A Review of Its Evolution, Current Advances, and Persistent Challenges in Ovarian Imaging.pubmed.ncbi.nlm.nih.gov
30. Pancreatic Cystic Lesions: A Focused Review on Cyst Clinicopathological Features and Advanced Diagnostics.pubmed.ncbi.nlm.nih.gov
31. Case Report: Isolated splenic hydatid cyst with negative serology managed by laparoscopic splenectomy.pubmed.ncbi.nlm.nih.gov
32. Albendazole Monotherapy and Spleen Preservation in an Adolescent with Isolated Primary Splenic Cystic Echinococcosis: A Case Report.pubmed.ncbi.nlm.nih.gov
33. Infected splenic artery pseudoaneurysm within a complex splenic cystic lesion: CT angiography pitfalls and surgical correlation.pubmed.ncbi.nlm.nih.gov
34. Case Report: Two rare cases of aggressive fibromatosis originating in the intestinal tract.pubmed.ncbi.nlm.nih.gov
35. Giant Congenital Splenic Cyst in a Pediatric Patient: A Case Report and Review of Surgical Management.pubmed.ncbi.nlm.nih.gov
36. Splenoses and Other Ectopic and Heterotopic Splenic Tissue: The Use of Long-Lasting Enhancement in Contrast-Enhanced Ultrasound to Avoid Unnecessary Intervention.pubmed.ncbi.nlm.nih.gov
37. Impact of structured reporting on interpretability of PSMA PET/CT in prostate cancer staging-towards standardised clinical implementation.pubmed.ncbi.nlm.nih.gov
38. Differentiating walled-off pancreatic necrosis with no documented pancreatitis from mucinous cystic neoplasms: a multicenter LASSO-based nomogram.pubmed.ncbi.nlm.nih.gov
39. MDCT Findings of Splenic Pathology.pubmed.ncbi.nlm.nih.gov
40. Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions.pubmed.ncbi.nlm.nih.gov
41. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Nonproliferative and Proliferative Lesions of the Rabbit.pubmed.ncbi.nlm.nih.gov
42. Giant adrenal pseudocyst with unclear preoperative origin: a case report and literature review.pubmed.ncbi.nlm.nih.gov
43. Laparoscopic Partial Splenectomy for a Giant Congenital Splenic Cyst in a Child: Case Report and Focused Literature Review.pubmed.ncbi.nlm.nih.gov
44. Incidental cystic pancreatic neuroendocrine neoplasm and differential diagnosis.pubmed.ncbi.nlm.nih.gov
45. Approach to Cystic Lesions in the Abdomen and Pelvis, with Radiologic-Pathologic Correlation.pubmed.ncbi.nlm.nih.gov
46. Primitive isolated hydatid cyst of the spleen: total splenectomy versus spleen saving surgical modalities.pubmed.ncbi.nlm.nih.gov
47. Benign focal liver lesions: The role of magnetic resonance imaging.pubmed.ncbi.nlm.nih.gov
48. Peritoneal disease: key imaging findings that help in the differential diagnosis.pubmed.ncbi.nlm.nih.gov
49. Incidental findings in female pelvis MRI performed for gynaecological malignancies.pubmed.ncbi.nlm.nih.gov
50. The Benign Side of the Abdominal Wall: A Pictorial Review of Non-Neoplastic Diseases.pubmed.ncbi.nlm.nih.gov
51. A resected case of pancreatic neuroendocrine neoplasm with completely cystic degeneration mimicking a mucinous cystic neoplasm: a case report and literature review.pubmed.ncbi.nlm.nih.gov
52. Endoscopic ultrasound-guided radiofrequency ablation for pancreatic cystic neoplasms: a comprehensive review.pubmed.ncbi.nlm.nih.gov
53. Imaging and Management of Incidental Renal Lesions.pubmed.ncbi.nlm.nih.gov
54. Case Report: Synchronous lingual osseous choristoma and suprahyoid thyroglossal duct cyst: insights into the embryological thyroglossal-hyoid axis.pubmed.ncbi.nlm.nih.gov
55. Rapidly Progressive Merkel Cell Carcinoma with Atypical Metastatic Pattern-A Case Report and Brief Literature Review.pubmed.ncbi.nlm.nih.gov
56. Rare pancreatic cystic neoplasms: A pictorial review.pubmed.ncbi.nlm.nih.gov
57. Rare anatomical localizations of hydatid cysts (2020-2025): Narrative review of presentation, imaging, and management.pubmed.ncbi.nlm.nih.gov
58. Primary Splenic Pregnancy: A Systematic Review of Published Case Reports.pubmed.ncbi.nlm.nih.gov
59. Large Symptomatic Splenic Pseudocyst: Case Report of a Rare Entity.pubmed.ncbi.nlm.nih.gov
60. A retrospective comparative study of CT and MRI findings of different types of pancreatic serous cystic neoplasms: Correlation with histopathology.pubmed.ncbi.nlm.nih.gov
61. Imaging findings of fatal embolic hemorrhagic stroke secondary to right ventricular hydatid cyst: A case report.pubmed.ncbi.nlm.nih.gov
62. Locally Aggressive Hepatic Echinococcosis With Colonic Involvement Requiring a Right Hemicolectomy: A Case Report and Focused Literature Review.pubmed.ncbi.nlm.nih.gov
63. Endoscopic ultrasound-guided radiofrequency ablation for large branch-duct intraductal papillary mucinous neoplasms: Safety and efficacy trial.pubmed.ncbi.nlm.nih.gov
64. An Overview for Clinicians on Intraductal Papillary Mucinous Neoplasms (IPMNs) of the Pancreas.pubmed.ncbi.nlm.nih.gov
65. Recurrent splenic epidermoid cyst in a young adult: A case report and literature review.pubmed.ncbi.nlm.nih.gov
66. Epidermoid Cysts in an Intrapancreatic Accessory Spleen Mimicking Pancreatic Neoplasms: Two Case Reports and a Literature Review of Japanese Cases.pubmed.ncbi.nlm.nih.gov
67. Traumatic rupture of an isolated splenic hydatid cyst: a rare and challenging surgical emergency.pubmed.ncbi.nlm.nih.gov
68. Cystic Neoplasms of the Pancreas: Differential Diagnosis and Radiology Correlation.pubmed.ncbi.nlm.nih.gov
69. Cystic pancreatic lesions: MR imaging findings and management.pubmed.ncbi.nlm.nih.gov
70. Minimally invasive surgery for giant splenic cysts.pubmed.ncbi.nlm.nih.gov
71. Radiological Approach to Splenomegaly: Etiologies, Pathophysiologies, and Diagnostic Strategies.pubmed.ncbi.nlm.nih.gov
72. Giant Intraabdominal Lymphangioma in a Pediatric Patient-A Challenging Diagnosis.pubmed.ncbi.nlm.nih.gov
73. Culture-negative cryptogenic splenic abscess in an immunocompetent host with recurrent misdiagnosis as pleural effusion: a case report with a review of the literature.pubmed.ncbi.nlm.nih.gov
74. Radiological Assessment After Pancreaticoduodenectomy for a Precision Approach to Managing Complications: A Narrative Review.pubmed.ncbi.nlm.nih.gov
75. Evaluating Microsoft Bing with ChatGPT-4 for the assessment of abdominal computed tomography and magnetic resonance images.pubmed.ncbi.nlm.nih.gov
76. Abdominal bronchogenic cyst: A rare case report.pubmed.ncbi.nlm.nih.gov
77. A Case of Pancreatic Pseudocyst Complicated by Pseudoaneurysm.pubmed.ncbi.nlm.nih.gov
78. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Non-proliferative and Proliferative Lesions of the Non-human Primate ( M. fascicularis ).pubmed.ncbi.nlm.nih.gov
79. Case Report: Delayed complications of endovascular treatment of recurrent erosive hemorrhage in necrotizing pancreatitis.pubmed.ncbi.nlm.nih.gov
80. Venous congestive ischemic colitis following left hemicolectomy: A rare case of superior rectal vein occlusion.pubmed.ncbi.nlm.nih.gov
81. Complications and expected imaging findings after endoscopic retrograde cholangiopancreatography.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.