背景:淋巴瘤(LH)是最常见的淋巴管瘤类型,但它很少发生在前臂。它可能显示局部侵入行为,但是是良性的。
方法:一位42岁的妇女出现在我们医院,她的右前臂有一个长条状肿块,3年前就发现了。超声检查显示右前臂皮下有一条下背声带。进一步的磁共振成像(MRI)显示LH特有的不规则带状扩张淋巴管,T1信号强度低,T2信号强度高。根治性手术切除后,用单克隆抗体D2-40标记的囊性LH内皮细胞的苏木精-伊红(H&E)和免疫组织化学(IHC)染色显示扩张的淋巴管瘤,没有恶性肿瘤的迹象。经过7个月的随访,未见肿瘤复发,疗效满意。
■先前创伤史的组合,症状和体征,影像学评估是必要的,以提供LH的线索,但最终的诊断可能是通过切除标本的病理评估。虽然有许多治疗方式,都有不同的结果。导致肿瘤残留的完全切除是LH复发的首要原因。因此,我们认为针对LH的首选方法仍然是完全手术切除。
结论:LH是良性的,通常无症状的病变,具有轻度的生物学行为。由于偶尔会有令人困惑的演示,类似的囊性病变仍应谨慎考虑。尽管MRI为其诊断提供了优越的优势,确诊仍需进行组织学检查.根治性病灶切除术是治疗LH的一种非常安全有效的选择。
BACKGROUND: Lymphoma hygroma (LH) that is the most common type of lymphangioma, but it rarely occurs in the forearm. It may show localized invasive behavior, but is benign.
METHODS: A 42-year-old woman presented to our hospital with a growing strip-like mass in the right forearm that had been detected 3 years earlier. Ultrasound examination showed a subcutaneous strip of low back vocal cords on the right forearm. Further magnetic resonance imaging (MRI) showed irregular strip-like dilated lymphatic vessels characteristic of LH with low T1 signal intensity and high T2 signal intensity. After radical surgical resection, hematoxylin-eosin (H & E) and immunohistochemical (IHC) staining of cystic LH endothelial cells labeled with monoclonal antibody D2-40 showed a dilated lymphangioma with no evidence of malignancy. After 7 months of follow-up, no tumor recurrence was seen and the effect was satisfactory.
UNASSIGNED: A combination of previous trauma history, signs and symptoms, and imaging evaluation are necessary to provide clues to LH, but the final diagnosis is likely to be made by pathologic evaluation of the resected specimen. Although there are many treatment modalities, all also have different outcomes. The absence of complete resection resulting in a tumor remnant is the foremost cause of LH recurrence, so we believe that the preferred approach against LH remains complete surgical resection.
CONCLUSIONS: LH is benign and generally asymptomatic lesions with mild bio-behavior. As there are occasional confusing presentations, similar cystic lesions should still be considered with caution for the disease. Although MRI provides superior advantages for its diagnosis, the confirmation of diagnosis still requires histological examination. Radical lesion resection is a very safe and effective option for the treatment of LH.