lymphangioma

淋巴管瘤
  • 文章类型: Case Reports
    介绍了一例75岁男子的食管淋巴管瘤,该男子抱怨吞咽困难恶化。内窥镜超声显示粘膜下层内蜂窝状或网格状多个微囊肿的回声模式。计算机断层扫描的矢状图像显示食管壁增厚,近端食管腔内积液。磁共振成像在T2加权成像和短tau反转恢复上显示出高信号强度质量,具有隔层状内部结构。通过内镜黏膜下剥离术将肿瘤完全切除。食管淋巴管瘤是一种罕见的粘膜下肿瘤,可以通过CT和/或MRI准确诊断。
    A case of esophageal lymphangioma in a 75-year-old man who complained of worsening dysphagia is presented. Endoscopic ultrasound showed an echogenic pattern of honeycomb or grid-like multiple microcysts within the submucosa. The sagittal image of computed tomography showed a thickened esophageal wall and fluid retention in the proximal esophageal lumen. Magnetic resonance imaging showed a high signal intensity mass with a septate-like internal structure on T2-weighted imaging and short tau inversion recovery. The tumor was completely resected by endoscopic submucosal dissection. Esophageal lymphangioma is a rare submucosal tumor that can be precisely diagnosed by CT and/or MRI.
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  • 文章类型: Journal Article
    背景:淋巴管瘤是浅表淋巴管畸形。舌状淋巴管瘤相对少见。已经报道了多种治疗方式,具有可变的治疗反应。大多数传统治疗方式的复发率很高。
    方法:我们描述了消融术在两名患者舌背周围淋巴管瘤治疗中的应用。口腔淋巴管瘤的射频消融显示术后早期口腔摄入和轻微的术后疼痛。随访1年无复发。
    结论:改善伤口愈合,术后早期口服和轻微的术后疼痛,使射频消融成为口腔淋巴管瘤的一种非常有价值的治疗方式,并可能被推荐为首选治疗方法。
    BACKGROUND: Lymphangioma is a malformation of superficial lymphatic vessels. Tongue lymphangiomas are relatively uncommon. Multiple treatment modalities have been reported, with variable treatment responses. Most of the traditional treatment modalities have a high recurrence rate.
    METHODS: We describe the use of coblation in the management of lymphangioma circumscriptum of the dorsum of tongue in two patients. Radiofrequency ablation of oral lymphangiomas showed early postoperative oral intake and minimal postoperative pain. There was no recurrence of disease on 1 year follow up.
    CONCLUSIONS: Improved wound healing, early postoperative oral intake and minimal postoperative pain, make radiofrequency ablation a highly valuable treatment modality for oral lymphangiomas and may be recommended as the treatment of choice.
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  • 文章类型: Case Reports
    淋巴管瘤是罕见的良性囊性肿瘤。手术切除是主要的治疗方法,旨在完全移除。诊断依赖于影像学和组织学确认。恶性转化异常罕见。我们报告了一名25岁的男子,他因脐周腹痛和腹部肿块而入院。影像学显示多房性腹膜囊性形成伴邻近肠系膜脂肪浸润。实验室发现并不显著,并进行剖腹探查术。发现了源自肠系膜的大量囊性肿块,需要肠处死才能完全切除。术后即刻恢复顺利。病理分析证实诊断为肠系膜囊性淋巴管瘤。在三年的随访中,患者的预后良好,没有肿瘤复发。我们强调完全手术切除对预防与囊性淋巴管瘤相关的并发症和降低复发风险的重要性。
    Lymphangiomas are rare benign cystic tumors. Surgical excision is the primary treatment, aiming for complete removal. Diagnosis relies on imaging and histological confirmation. Malignant transformation is exceptionally rare. We report a 25-year-old man admitted for peri-umbilical abdominal pain and an abdominal mass. Imaging revealed multilocular peritoneal cystic formations with infiltration of adjacent mesenteric fat. Laboratory findings were unremarkable, and exploratory laparotomy was performed. A voluminous cystic mass originating from the mesentery was discovered, requiring intestinal sacrifice for complete resection. Immediate postoperative recovery was smooth. Pathological analysis confirmed the diagnosis of mesenteric cystic lymphangioma. The patient had a favorable outcome with no tumor recurrence at a three-year follow-up. We emphasize the significance of complete surgical removal to prevent complications associated with cystic lymphangioma and reduce the risk of recurrence.
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  • 文章类型: Journal Article
    背景:淋巴畸形是血管发育异常,从局部浅表肿块到弥漫性浸润病变,导致毁容。尽管进行了适当的治疗,但患者的预后范围从自发消退到严重的后遗症。当前的分类指南,在某种程度上,临床医生通过决策过程,预后预测和治疗策略的选择。尽管对这种疾病的分子基础的理解最近得到了改善,尚未达到标准化的管理算法。
    结果:这里,我们报告了我们对5例头颈部不同淋巴异常患儿的治疗经验,这些患儿采用多学科方法,在专家之间就解决问题和确定优先事项达成共识.
    结论:尽管很少实现完全恢复,而且患者的护理负担具有挑战性,护理人员和医疗保健提供者,这项研究证明了转诊专家中心如何通过减轻父母的压力和改善患者的生活质量来显著改善结局.提出了一个流程图,以指导患有LMs的儿童的多学科护理,并鼓励多学科协作计划实施专门的患者路径。
    BACKGROUND: Lymphatic malformations are vascular developmental anomalies varying from local superficial masses to diffuse infiltrating lesions, resulting in disfigurement. Patients\' outcomes range from spontaneous regression to severe sequelae notwithstanding appropriate treatment. The current classification guides, in part, clinicians through the decision-making process, prognosis prediction and choice of therapeutic strategies. Even though the understanding of molecular basis of the disease has been recently improved, a standardized management algorithm has not been reached yet.
    RESULTS: Here, we report our experience on five children with different lymphatic anomalies of the head and neck region treated by applying a multidisciplinary approach reaching a consensus among specialists on problem-solving and setting priorities.
    CONCLUSIONS: Although restitutio ad integrum was rarely achieved and the burden of care is challenging for patients, caregivers and healthcare providers, this study demonstrates how the referral to expert centres can significantly improve outcomes by alleviating parental stress and ameliorating patients\' quality of life. A flow-chart is proposed to guide the multidisciplinary care of children with LMs and to encourage multidisciplinary collaborative initiatives to implement dedicated patients\' pathways.
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  • 文章类型: Case Reports
    卵巢淋巴管瘤是罕见的良性肿瘤,其特征是卵巢组织内淋巴管的增殖。虽然淋巴管瘤可以表现在各种解剖位置,它们在卵巢内的发生异常罕见,给临床医生带来诊断和治疗挑战。卵巢淋巴管瘤的病因仍然难以捉摸,理论表明先天性畸形,淋巴阻塞,或获得性淋巴增生是潜在的促成因素。卵巢淋巴管瘤的临床表现通常包括非特异性症状,如腹痛,肿胀,或不适,导致早期发现和诊断困难。放射成像,特别是超声,CT(计算机断层扫描)和MRI(磁共振成像),在识别这些病变和指导后续处理策略方面起着至关重要的作用.尽管它们通常是良性的,卵巢淋巴管瘤可以达到显著的大小,引起扭转等并发症,破裂,或压缩相邻结构。手术干预,通常在膀胱切除术或卵巢切除术中,经常追求缓解症状和预防潜在的并发症。本文旨在全面回顾卵巢淋巴管瘤的现有文献,解决他们的临床表现,诊断挑战,和管理策略。通过综合现有数据,我们寻求增强我们对这个稀有实体的理解,为遇到类似病例的临床医生提供有价值的见解。提高对卵巢淋巴管瘤的认识和知识对于及时诊断和最佳患者预后至关重要。
    Ovarian lymphangiomas are rare benign neoplasms characterized by the proliferation of lymphatic vessels within the ovarian tissue. While lymphangiomas can manifest in various anatomical locations, their occurrence within the ovaries is exceptionally uncommon, posing diagnostic and therapeutic challenges for clinicians. The aetiology of ovarian lymphangiomas remains elusive, with theories suggesting congenital malformations, lymphatic obstruction, or acquired lymphatic proliferation as potential contributing factors. The clinical presentation of ovarian lymphangiomas often includes nonspecific symptoms such as abdominal pain, swelling, or discomfort, leading to difficulties in early detection and diagnosis. Radiological imaging, particularly Ultrasound, CT (computed tomography) and MRI (magnetic resonance imaging), plays a crucial role in identifying these lesions and guiding subsequent management strategies. Despite their generally benign nature, ovarian lymphangiomas can attain significant sizes, causing complications such as torsion, rupture, or compression of adjacent structures. Surgical intervention, typically in cystectomy or oophorectomy, is frequently pursued to alleviate symptoms and prevent potential complications. This paper aims to comprehensively review the existing literature on ovarian lymphangiomas, addressing their clinical presentation, diagnostic challenges, and management strategies. By synthesizing available data, we seek to enhance our understanding of this rare entity, providing valuable insights for clinicians encountering similar cases. Improved awareness and knowledge of ovarian lymphangiomas are essential for timely diagnosis and optimal patient outcomes.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    囊性水瘤(CH)也称为淋巴管瘤,是淋巴管的囊性畸形,可以发生在身体的任何地方。它在成年期的发病率被认为是罕见的,它在颈部的发生甚至更罕见,迄今为止只有少数病例报告可用。我们介绍一例成人颈部CH,并对其进行文献综述。一名30岁男性,颈部左侧无痛性肿胀,持续时间2年。调查显示,颈部左下前部有一个囊性肿块,通过手术切除完整的囊。活检报告证实了诊断。当成人颈部遇到囊性病变时,应考虑CH的鉴别诊断。细胞学和放射学评估对于确定其位置和诊断是必要的。尽管有各种保守的管理方式,他们只在某些情况下被雇用,手术切除CH被认为是黄金标准。复发的几率从15%到20%不等。
    Cystic Hygroma (CH) also referred to as lymphangioma, is a cystic malformation of the lymphatic vessels that can occur anywhere in the body. Its incidence in adulthood is considered rare and its occurrence in the neck is even rarer and only a few case reports are available till date. We present a case of adult CH of the neck and the literature review of the same. A 30-year-old male presented with painless swelling in the left side of the neck of 2 years duration. Investigations showed a cystic mass on the left lower anterior part of the neck which was surgically removed in-toto with the intact capsule. The biopsy report confirmed the diagnosis. A differential diagnosis of CH should be considered when a cystic lesion is encountered in the neck of an adult, cytological and radiological evaluation is necessary for defining its location and diagnosis. Although various conservative modalities of management are available, they are employed only in certain situations, and surgical excision of CH is considered the gold standard. The chances of recurrence range from 15 to 20%.
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  • 文章类型: Case Reports
    此病例报告描述了在怀孕期间诊断为腹膜后囊性肿瘤的妇女的管理。29岁的患者在怀孕29周时出现腹痛。在超声和磁共振成像中鉴定出尺寸为224×156×235mm的腹膜后肿瘤。该患者在37周时接受了健康新生儿的剖宫产分娩。产后期间进行了简单的腹腔镜手术,导致腹膜后淋巴管瘤的组织学诊断。回顾了2003年至2023年之间发表的关于诊断的文章,管理,妊娠淋巴管瘤的预后是使用PubMed进行的,SCOPUS和SpringerLink数据库。十篇文章,包括怀孕期间诊断的淋巴管瘤的病例报告,已确定。最常见的位置是胃肠道,腹膜后区域无病例报告。大多数病例报告了良好的围产期结局。淋巴管瘤是罕见的良性肿瘤,在怀孕期间更为罕见。警惕的等待可以提供良好的产科和围产期预后。
    This case report describes the management of a woman diagnosed with a retroperitoneal cystic tumor during pregnancy. The 29-year-old patient presented at 29 weeks of pregnancy with abdominal pain. A retroperitoneal tumor measuring 224 × 156 × 235 mm was identified on ultrasound and magnetic resonance imaging. The patient underwent cesarean section delivery of a healthy neonate at 37 weeks. Uncomplicated laparoscopic surgery was performed during the postpartum period, resulting in a histologic diagnosis of a retroperitoneal lymphangioma. A review of articles published between 2003 and 2023 on the diagnosis, management, and prognosis of gestational lymphangiomas was conducted using the PubMed, SCOPUS and SpringerLink databases. Ten articles, including case reports of lymphangiomas diagnosed during pregnancy, were identified. The most frequent location was the gastrointestinal tract, with no cases reported in the retroperitoneal area. A good perinatal outcome was reported in the majority of cases. Lymphangiomas are rare benign tumors that are even more uncommon during pregnancy. Watchful waiting can offer a good obstetric and perinatal prognosis.
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  • 文章类型: Journal Article
    舌肿瘤比较常见,绝大多数是上皮表型。虽然不常见,在这个解剖部位出现了多样化和独特的间充质肿瘤。为了增加我们对这些病变的了解,我们回顾了我们的经验,并描述了他们的临床病理特征。从2005-2021年的病理档案和其中一位作者的咨询文件中查询了所有舌头的MN。我们回顾了组织学切片和辅助研究,并从可用的医疗记录中获得了临床数据。确认了93例病例,他们组成了研究队列——据我们所知,这是最大的舌间充质肿瘤系列。48名患者为女性,45人是男性,平均年龄51岁(范围:1-94岁)。肿瘤包括43例(46.2%)血管瘤,14(15%)个颗粒细胞瘤,8(9%)脂肪瘤,4例(4.3%)神经鞘瘤,4例(4.3%)孤立性纤维瘤-根据风险分层标准,均具有较低的进展风险,2例(2.2%)淋巴管瘤,3(3.2%)卡波西肉瘤,2(2.2%)软骨瘤,2(2.2%)肌纤维瘤,1例(1.1%)孤立性局限性神经瘤,1(1.1%)神经鞘瘤,1(1.1%)神经纤维瘤,1(1.1%)外胚间充质软骨粘液样肿瘤,1例(1.1%)具有NOTCH2重排和TLL2突变的非典型血管球瘤,1(1.1%)梭形细胞横纹肌肉瘤,1(1.1%)多形性成纤维细胞肉瘤,1例(1.1%)恶性横纹肌样瘤,1(1.1%)平滑肌肉瘤,1(1.1%)血管肉瘤,1例(1.1%)肺泡软组织肉瘤。大多数患者接受了手术切除,1例(血管瘤)患者行栓塞治疗。关于后续行动,梭形细胞横纹肌肉瘤患者在手术部位出现术后麻木,随访17个月后无病.患有平滑肌肉瘤的患者在22个月时拒绝辅助放疗并发生肺部转移。患有肺泡软组织肉瘤的患者在诊断时已转移到肺,并接受了辅助化疗。其余患者无局部或远处复发。舌头的MNs通常是良性的,其特征是内皮,脂肪细胞,或schwannian分化。治疗的主要方法是手术切除,切除程度由肿瘤类型决定。辅助治疗保留用于高级别肉瘤。
    Neoplasms of the tongue are relatively common, and the vast majority are epithelial in phenotype. Although uncommon, a diverse and distinctive array of mesenchymal neoplasms arises in this anatomic site. To increase our understanding of these lesions, we reviewed our experience of MNs of the tongue and described their clinicopathologic features. The pathology archives from 2005 to 2021 and the consultation files of one of the authors were queried for all MNs of the tongue. We reviewed the histologic slides and ancillary studies and obtained clinical data from the available medical records. Ninety-three cases were identified, and they form the study cohort - to our knowledge, this is the largest series of mesenchymal neoplasms of the tongue. Forty-eight patients were female, and forty-five were male, with a mean age of 51 years (range: 1-94 years). The tumors included 43 (46.2%) hemangiomas, 14 (15%) granular cell tumors, 8 (9%) lipomas, 4 (4.3%) schwannomas, 4 (4.3%) solitary fibrous tumors - all with low risk of progression based on risk stratification criteria, 2 (2.2%) lymphangiomas, 3 (3.2%) Kaposi sarcomas, 2 (2.2%) chondromas, 2 (2.2%) myofibromas, 1 (1.1%) solitary circumscribed neuroma, 1 (1.1%) perineurioma, 1 (1.1%) neurofibroma, 1 (1.1%) ectomesenchymal chondromyxoid tumor, 1 (1.1%) atypical glomus tumor with a NOTCH2 rearrangement and TLL2 mutation, 1 (1.1%) spindle cell rhabdomyosarcoma, 1 (1.1%) pleomorphic fibroblastic sarcoma, 1 (1.1%) malignant rhabdoid tumor, 1 (1.1%) leiomyosarcoma, 1 (1.1%) angiosarcoma, and 1 (1.1%) alveolar soft part sarcoma. Most of the patients underwent surgical excision, and 1 patient (with hemangioma) underwent embolization. On follow-up, the patient with spindle cell rhabdomyosarcoma developed postoperative numbness at the surgical site and was disease-free through 17 months of follow-up. The patient with leiomyosarcoma declined adjuvant radiation and developed metastasis to the lung at 22 months. The patient with alveolar soft part sarcoma had metastases to the lung at the time of diagnosis and received adjuvant chemotherapy. The remaining patients had no local or distant recurrence. MNs of the tongue are usually benign and characterized by either endothelial, adipocytic, or schwannian differentiation. The mainstay of treatment is surgical excision with the extent of excision determined by tumor type. Adjuvant therapy is reserved for high-grade sarcomas.
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  • 文章类型: Case Reports
    孤立的脾淋巴管瘤是罕见的良性病变,主要见于儿童,在成人中极为罕见。通常由于其典型的无症状性质而偶然发现。该病例报告详细介绍了一名33岁女性罕见的脾脏囊性淋巴管瘤的手术切除,强调这些肿瘤带来的诊断和治疗挑战。病人的症状,腹痛和明显的肿块导致超声和CT成像,显示了一个囊性脾脏病变。行全脾切除术,显示出一个巨大的囊性肿块,病理检查证实为囊性淋巴管瘤。该病例强调了在出现脾病变的成年患者中考虑脾淋巴管瘤的必要性。它还强调了手术干预对于明确诊断和预防破裂和出血等并发症的关键作用,从而强调了罕见脾肿瘤治疗的复杂性。
    Isolated splenic lymphangiomas are rare benign lesions mostly seen in children are exceptionally rare in adults, often discovered incidentally due to their typically asymptomatic nature. This case report elaborates on the surgical excision of a rare splenic cystic lymphangioma in a 33-year-old woman, underscoring the diagnostic and therapeutic challenges these tumors pose. The patient\'s symptoms, abdominal pain and a palpable mass led to imaging through ultrasound and CT, which revealed a cystic splenic lesion. Total splenectomy was performed, revealing a large cystic mass, with pathological examination confirming a cystic lymphangioma. This case emphasizes the necessity of considering splenic lymphangiomas in adult patients presenting with splenic lesions. It also highlights the critical role of surgical interventions for definitive diagnosis and to prevent complications such as rupture and hemorrhage, thereby emphasizing on the complexity of managing rare splenic tumors.
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