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Abstract：
Massive localized lymphedema (MLL) is a rare disease caused by the obstruction of lymphatic vessels with specific clinical morphological and radiological characteristics. People with morbid obesity are mainly affected by MLL. Lymphedema is easily confused with soft tissue sarcoma and requires differential diagnosis, both the possibility of an MLL and also carcinoma manifestations in the soft tissues. The possible causes of massive lymphedema include trauma, surgery, and hypothyroidism. This report is the first case of MLL treated surgically in the Russian Federation. Detailed computed tomography (CT) characteristics and an electron microscope picture of MLL are discussed. A 50-year-old woman (body mass index of 43 kg/m 2 ) with MLL arising from the anterior abdominal wall was admitted to the hospital for surgical treatment. Its mass was 22.16 kg. A morphological study of the resected mass confirmed the diagnosis of MLL. We review etiology, clinical presentation, diagnosis, and treatment of MLL. We also performed an electron-microscopic study that revealed interstitial Cajal-like cells telocytes not previously described in MLL cases. We did not find similar findings in the literature. It is possible that the conduction of an ultrastructural examination of MLL tissue samples will further contribute to the understanding of MLL pathogenesis.
摘要：
大规模局部淋巴水肿(MLL)是由淋巴管阻塞引起的罕见疾病,具有特定的临床形态学和影像学特征。病态肥胖患者主要受MLL的影响。淋巴水肿容易与软组织肉瘤混淆，需要鉴别诊断。MLL的可能性以及软组织中的癌表现。大量淋巴水肿的可能原因包括外伤,手术,和甲状腺功能减退。本报告是俄罗斯联邦首例MLL手术治疗。讨论了MLL的详细计算机断层扫描（CT）特征和电子显微镜照片。一名50岁的妇女（体重指数为43kg/m2），由前腹壁引起的MLL被送往医院接受手术治疗。其质量为22.16kg。切除肿块的形态学研究证实了MLL的诊断。我们回顾病因，临床表现,诊断,MLL的治疗。我们还进行了电子显微镜研究，揭示了先前在MLL病例中未描述的间质Cajal样细胞端细胞。我们在文献中没有发现类似的发现。MLL组织样品的超微结构检查的传导可能将进一步有助于对MLL发病机理的理解。
