Gastrointestinal sistem kaynaklı konjenital nadir görülen kistik lezyonların histopatolojik değerlendirmesi

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.

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.

Keywords:

Mesenteric cysts, duplication cysts, meckel diverticulum,

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