Aksesuar dalak veya kalsifiye nodun adneksiyel kitle taklidi

Özet

Pelvik aksesuar dalak çok nadirdir ve adneksiyel kitlelerin ayırıcı tanısında düşünülebilir. Dinamik BT’de pelvik kitleyi besleyen damarların omentumdan veya splenik hilustan kaynaklandığının belirlenmesi aksesuar dalak tanısına yardımcı olabilir. Dinamik BT’de pelvik kitlenin homojen kontrastlanması ve besleyici damarlarının omental arterden veya splenik hilustan kaynaklandığının gösterilmesi aksesuar dalak tanısını destekleyebilir. Pelvik kitlede besleyici damar sapının dinamik BT’de fark edilmesi, aksesuar dalak tanısının ameliyat öncesinde konmasına yardımcı olabilir.

Faz ve pencere

Arteriyel tanısal

Dinamik BT’de pelvik kitlenin homojen kontrastlanması görülebilir; bildirilen olguda bu bulgu tek başına ameliyat öncesi tanıyı kolaylaştırmamıştır.

Portal tanısal

Pelvik aksesuar dalak olasılığında nodülün MRI sinyal örüntüsünün dalakla benzerliği karşılaştırılabilir.

BT bulguları

• Pelvik aksesuar dalak, adneksiyel kitlelerin ayırıcı tanısında düşünülebilir.
• Pelvik aksesuar dalak olasılığında nodülün MRI sinyal örüntüsü dalakla benzer olabilir.
• Damar sapı — pelvik nodüle uzanan ince damar demeti omental veya splenik hilus kökenini destekler; dinamik BT’de izlenebilir.
• Normal overin gösterilmesi — ipsilateral overin ayrı ve morfolojik olarak korunmuş görünmesi, kitlenin over kaynaklı olma olasılığını azaltır.
• Pelvik aksesuar dalakta besleyici damar sapı büyük omentumdan veya splenik hilustan kaynaklanabilir; bu damarların dinamik BT’de kökenini belirlemek tanıya yardımcı olabilir.
• Splenozis öyküsü — geçirilmiş splenektomi veya travma varsa peritoneal yüzeylerde birden fazla splenik implant görülebilir; bu, konjenital aksesuar dalaktan farklı edinilmiş dağılımdır.
• Pelvik aksesuar dalak ayırıcı tanısında büyümüş lenf nodları da değerlendirilir.

Normalde

Pelvik kitle değerlendirilirken overler ve uterus normal anatomik konumlarında saptanırsa, lezyonun içeriği ve kökeni ayırıcı tanıyı daraltmaya yardımcı olabilir. Pelvik kitle değerlendirmesinde iki over ve uterusun normal anatomik konumlarında görülmesi, lezyonun içeriği ve kökeniyle birlikte ameliyat öncesi ayırıcı tanıyı daraltmaya yardımcı olabilir.

Ayırıcı tanı

Over tümörleri, pelvik aksesuar dalağın ayırıcı tanısında değerlendirilebilir.

Subseröz miyom, pelvik aksesuar dalak ayırıcı tanısında değerlendirilen adneksiyel kitle nedenlerinden biridir.

Lenf nodu büyümesi (lenfadenopati), pelvik aksesuar dalak ayırıcı tanısında değerlendirilebilen nodal yapılardandır.

Tubo-ovaryan apse, pelvik aksesuar dalak ayırıcı tanısında değerlendirilebilecek bir adneksiyel kitle nedenidir.

Peritoneal maligniteler, pelvik ve peritoneal kitlelerin görüntüleme ayırıcı tanısında değerlendirilir.

Tuzaklar

• Pelvik aksesuar dalak olgusunda dinamik BT’de kitle homojen kontrastlanabilir; bu görünüm tanıyı tek başına kesinleştirmez.
• Pelvik aksesuar dalak için yayınlar nadir olgulara dayanır; her dalakla benzer nodülü kesin tanı gibi raporlama, konum ve damar bağlantısını birlikte doğrula.
• Splenozis çoğunlukla travma veya splenektomi sonrası edinilmiş implantasyondur; aksesuar dalak konjenital ve ayrı splenik doku odağıdır.
• Büyümüş lenf nodları, pelvik aksesuar dalağın ayırıcı tanısında değerlendirilmelidir.

Kendini dene

1. Pelvik kitleye uzanan uzun damar sapının splenik arterden kaynaklandığı ve splenik vene döküldüğü gösteriliyor. En olası tanı hangisidir?

   • Pelvik aksesuar dalak
   • Over fibromu
   • Subseröz miyom
   • Kalsifiye lenf nodu
   Cevabı göster

   Pelvik aksesuar dalak. Splenik arterden kaynaklanıp splenik vene dökülen damar sapı, pelvik kitlede aksesuar dalak tanısını destekler.

2. Pelviste solid bir kitle saptanıyor. Dinamik BT’de homojen kontrastlanmasına ek olarak omental kökenli besleyici damar sapı görülüyor. En olası tanı hangisidir?

   • Aksesuar dalak
   • Over kanseri
   • Lenfadenopati
   • Miyom
   Cevabı göster

   Aksesuar dalak. Omental veya splenik hilus kökenli besleyici damar sapı pelvik aksesuar dalak tanısını destekleyebilir.

İlgili konular

• Tesadüfi adneksiyel kist veya kitle
• Pelvik peritoneal karsinomatozis ve implantlar

Kaynaklar

Bu sayfadaki 36 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 22 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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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.