肝囊性淋巴管瘤2例报告并国内文献回顾

目的:探讨肝囊性淋巴管瘤的临床特点和诊治方法,以提高诊断率及治疗效果。方法:回顾性分析广东医科大学附属医院收治的2例成人肝囊性淋巴管瘤患者临床资料及诊疗过程,并检索、复习中文期刊数据库中肝囊性淋巴管瘤的文献。结果:笔者收治的2例患者,均为女性,入院诊断分别为肝囊性占位和肝囊肿;患者完善相关检查后行肝切除术,术后病理诊断肝囊性淋巴管瘤;患者术后随访均无复发,治疗满意。检索1984—2017年期间国内共报道6例患者,其中男4例,女2例;入院诊断肝囊淋巴管瘤2例(2/6);其他均误诊(4/6),6例患者均行手术切除后明确诊断,术后患者恢复满意。结论:肝囊性淋巴管瘤为临床罕见的肝脏良性疾病。临床症状、体征及影像学表现无特异性,临床易误诊为肝囊肿及其他囊性疾病;MRl有助于鉴别诊断;有明确症状、体征或不能排除恶性的患者应结合个体情况制定治疗方案,病理检查是明确诊断的唯一方法。     

腹膜后囊性淋巴管瘤的CT诊断及治疗(附5例报道)

目的 探讨腹膜后囊性淋巴管瘤的CT诊断价值和治疗方法.方法 回顾性分析2004年6月至2010年5月期间我院收治的5例经病理检查证实的腹膜后囊性淋巴管瘤患者的临床表现、CT影像特征、手术治疗及术后随访的资料.结果 5例患者术前CT均诊断为囊性淋巴管瘤,均行手术完整切除肿瘤,术后病理结果均证实为囊性淋巴管瘤.术后7 d顺利出院,随访3个月～6年均无复发.结论 CT对腹膜后囊性淋巴管瘤的诊断具有重要意义,手术完整切除整个囊壁是治疗及预防术后复发的最好方法.     

后腹腔镜治疗腹膜后囊性淋巴管瘤2例报告并文献复习

目的提高对腹膜后囊性淋巴管瘤的认识,探讨其诊治方法。方法报告2例经本院收治的腹膜后淋巴管瘤患者的临床资料,回顾性分析其临床特征及影像学表现。2例均为女性,年龄分别为39岁及45岁。患者均无特征性临床表现。超声及CT均表现为边缘光整的囊性肿块。2例患者均在全麻下行腹腔镜腹膜后肿物切除术,并检索Pubmed和CBM数据库,对该疾病相关文献进行复习。结果 2例均成功切除病灶并经病理诊断为腹膜后囊性淋巴管瘤。术后随访5和24个月,未发现肿瘤复发。结论腹膜后囊性淋巴管瘤临床上少见,该病多无特征性临床表现,B超及CT检查对协助术前诊断及手术均有重要指导意义。腹腔镜手术治疗腹膜后囊性淋巴管瘤安全有效。     

肾囊性淋巴管瘤一例报告及文献复习

目的 探讨肾囊性淋巴管瘤的临床诊治特点。方法报告1例肾囊性淋巴管瘤患者临床资料，结合 文献复习讨论。患者男性，38岁。主要临床表现为血尿、腰部钝痛、肾绞痛和肾区肿块，B超、CT、检查显示为囊性病变，内有分隔，囊液回声、密度、信号显示为水性、浆液性、血性。结果患者经开放性手术治疗后痊愈。术后病理检查囊壁内发现平滑肌及内衬上皮细胞，囊壁和囊腔内发现淋巴细胞。患者术后随访6个月未见复发。结论 肾囊性淋巴管瘤B超、CT、MRI检查无特征性改变时，经皮细针穿刺活检和囊液细胞学检查可能有助于诊断。确诊需病理组织学检查。外科治疗效果良好。     

腹膜后囊性淋巴管瘤的诊断与治疗

目的探讨腹膜后囊性淋巴管瘤的诊断与治疗。方法收集经病理证实的成人腹膜后囊性淋巴管瘤7例,回顾性分析其临床特征及影像学表现,并与手术、病理结果对照。其中男2例,女5例,平均年龄51岁。患者均无特征性临床表现。超声及CT均表现为边缘光整的囊性肿块,病变大小约6cm×7cm～20cm×21cm,部分囊内有分隔,且壁与分隔可部分强化。术前诊断腹膜后囊性占位病变4例,腹腔囊肿2例,仅1例患者经CT引导下穿刺抽液确诊。结果7例均行手术治疗,完整切除肿瘤者6例,1例因肿瘤浸润肝脏及胰腺仅行大部切除。术后病理报告证实为:(腹膜后)囊性淋巴管瘤。7例随访9个月～10年,完整切除者均未见复发,大部切除者于术后5个月出现局部复发。结论超声及CT对腹膜后囊性淋巴管瘤定位、定性诊断具有重要价值,手术切除是治疗首选。     

腹膜后囊性淋巴管瘤的诊断与治疗

目的探讨腹膜后囊性淋巴管瘤的诊断与治疗。方法收集经病理证实的成人腹膜后囊性淋巴管瘤5例，回顾性分析其临床表现及影像学特征，并与手术及病理结果进行对照分析。其中男性2例，女性3例，平均年龄38．0岁。患者无特异性临床表现，均为常规体检时经B超检查发现。经CT及MRI检查均考虑：腹膜后囊性淋巴管瘤可能。结果5例均行手术治疗并完整切除，术后恢复顺利，随访3个月至16个月均无复发。结论腹膜后囊性淋巴管瘤多无特异性临床表现，CT及MRI检查对术前协助诊断及对手术均有重要指导意义。手术切除为首选治疗方式，术中应尽可能完整切除病变，以防术后复发。     

小儿睾丸卵黄囊瘤合并鞘膜积液诊治分析(附7例报告)

目的:提高小儿睾丸卵黄囊瘤的诊治水平,探讨小儿睾丸卵黄囊瘤合并鞘膜积液的临床特点及其中关联。方法:回顾性分析2008年9月至2012年4月收治7例睾丸卵黄囊瘤合并大量鞘膜积液患儿的临床资料。7例均初步诊断为睾丸卵黄囊瘤,临床Ⅰ期。术中快速病理证实为卵黄囊瘤后,行根治性高位精索睾丸切除术。7例术后随访时间3⁴1个月,按术后第1年每个月;第2年每3个月;第3年每6个月随访。内容包括常规体检、血清甲胎蛋白(AFP)、胸片、B超及CT。结果:7例术后病理均证实为睾丸卵黄囊瘤,未累及精索切缘端。6例术后1个月内血清AFP降至正常,诊断为临床Ⅰ期,未行化疗,无复发、转移;1例术后1个月血清AFP116μg/L,诊断为临床Ⅱ期,予PVB方案化疗,术后3个月失访。结论:小儿睾丸卵黄囊瘤合并鞘膜积液易于误诊,应常规检查B超。Ⅰ期患儿可单纯行根治性高位精索睾丸切除术,术后需密切随访;Ⅱ期患儿术后辅以联合化疗。目前尚无证据支持小儿睾丸卵黄囊瘤与鞘膜积液存在关联,其预后与同期病例相仿。     

精索侵袭性血管黏液瘤1例报告并文献复习

目的:分析1例精索侵袭性血管黏液瘤的临床表现、影像学和病理学特点以探讨其诊疗方式及预后。方法:回顾性分析我院2014年1月收治的1例精索侵袭性血管黏液瘤患者的临床资料,患者术前无特异性临床表现,术前诊断为阴囊肿物,遂行阴囊肿物切除术。结果:术后病理检查诊断为侵袭性血管黏液瘤,随访24个月肿瘤无复发和转移。结论:精索侵袭性血管黏液瘤较为罕见仅能依靠病理检查确诊;临床上容易与其他阴囊肿瘤混淆,手术切除是目前最为有效的治疗方式.因为该肿瘤的高复发性,需密切随访。     

精索旁侵袭性血管黏液瘤的临床特征(附2例报告及复习文献)

目的探讨精索旁侵袭性血管黏液瘤的临床特征。方法报告2例精索旁侵袭性血管黏液瘤患者的临床资料,结合文献复习进行讨论。结果2例患者的精索旁侵袭性血管黏液瘤均手术完整切除,经随访6~8个月,无肿瘤复发。病理诊断为精索旁侵袭性血管黏液瘤。结论侵袭性血管黏液瘤临床罕见,在男性好发于精索旁,确诊依赖病理学检查,治疗需手术完整切除肿瘤,术后应长期严密随访。     

纵隔囊性淋巴管瘤的诊断和治疗

纵隔囊性淋巴管瘤的诊断和治疗张合林，白世祥，王新，平育敏１９６５年１月至１９９４年１月，我们收治各类纵隔肿瘤及囊肿４２６例，其中囊性淋巴管瘤仅９例，占２．ｌｌ％。均经手术摘除及病理证实，现结合文献报道如下：临床资料本组男８例，女１例。年龄１９～５６岁...     

Lymphangioma of the spermatic cord

We report a new case of spermatic cord lymphangioma in a infant 2 years old. The initial diagnosis was funicular hydrocele. The treatment was the local excision of tumor and the diagnostic was histological. Postoperative course was excellent. Must be explored the transillumination of the mass which would have led us to think other the diagnosis different from that of the cord hydrocele before the operation since it would have given negative. During the operation, must the assured that the cystic anomaly is limited to spermatic cord, to evite recurrences in the postoperative course.     

Scrotal lymphangioma in an adult

We present a case of scrotal lymphangioma in a 25-year-old man. The patient presented with scrotal swelling and an ultrasound scan demonstrating a complex extratesticular cystic mass around the left spermatic cord. He underwent excision of the mass, followed by orchiectomy for recurrence. This case was interesting for several reasons. First, scrotal lymphangioma, although very rare, is usually seen in infants and children. Second, for a symptomatic extratesticular cystic mass, surgery might be warranted. Finally, although primary excision is the treatment of choice in the younger individual, the same might not be true for the rare adult with this disease.     

Cystic lymphangioma of the kidney: Diagnosis and management

INTRODUCTION: Cystic lymphangioma is a rare benign vascular tumor that may arise in various sites, revealed at any age. Abdominal locations represent less than 10% of the cases preferentially involving the mesentery. We report a case of primary lymphangioma arising from the kidney. PRESENTATION OF CASE: A 50-year-old woman was admitted for severe left lumbar pain. Abdominal ultrasonography and computed tomography revealed a 6×10 cm multiloculated cystic mass with hydronephrosis, extending along the left renal hilum. Surgical exploration revealed a retroperitoneal cystic tumor. Anatomopathologic examination concluded it to be a cystic lymphangioma. DISCUSSION: The cystic lymphangioma is a benign malformative tumor of the lymphatic system. Surgery is the best curative treatment with complete excision, the prognosis is excellent. CONCLUSION: Primary renal lymphangioma is exceedingly rare. Medical imaging has certain limits for the diagnosis which required histological confirmation. The treatment of choice is surgical.     

Laparoscopic excision of a retroperitoneal cystic lymphangioma in an elderly patient

A 68-year-old male patient was referred to our hospital due to protrusion and pain in the right iliac fossa. On physical examination a palpable oval tumor was found. Ultrasonography and computed tomography revealed a cystic mass in right iliac fossa. The tumor was successfully excised laparoscopically and histologically diagnosed as cystic lymphangioma. Retroperitoneal cystic lymphangiomas are rare lesions, most often seen in pediatric patients. Surgical excision is the treatment of choice because of its potential to grow and develop complications, especially due to mass effect. The laparoscopic approach is a safe and effective alternative for treatment of retroperitoneal cystic lymphangioma in the elderly.     

Malignant mesenchymoma of the spermatic cord

Sarcomas of the spermatic cord are rare, with only approximately 200 such tumors reported in the literature. Of those cases only 3 fit the definition of malignant mesenchymoma: a mesenchymal tumor with 2 or more malignant elements other than fibrosarcoma. We report the fourth such case treated by local excision alone. The patient was free of disease 6 years after treatment.     

Total laparoscopic excision of retroperitoneal cystic lymphangioma

Retroperitoneal cystic lymphangioma is a rare benign tumor of the retroperitoneal lymphatics that usually manifests in infancy. If surgical excision is used in treatment, it needs to be as complete as possible to reduce the risk of recurrence. Two pediatric patients, an 18-month-old girl and a 4-yearold boy, underwent laparoscopic excision of symptomatic retroperitoneal cystic lymphangiomas. Macroscopically, the resection was complete in both cases. The postoperative course in both cases was uneventful. Both children remained asymptomatic and no recurrence was observed at 18-month follow-up. Complete laparoscopic excision should be considered as a therapeutic option to treat retroperitoneal cystic lymphangioma.     

Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection.

PURPOSE: Four patients who underwent retroperitoneal lymph node dissection elsewhere and subsequently had radiographic evidence of expanding ipsilateral paracolic recurrence were referred to our institution for treatment. We evaluated ipsilateral spermatic cord metastatic involvement at retroperitoneal lymph node dissection and identified the possible etiology of these unusual recurrences. MATERIALS AND METHODS: Between January 1988 and February 1998, 34 of 685 patients who underwent a total of 702 retroperitoneal lymph node dissections had metastatic disease in the spermatic cord specimen. Variables examined in this group of patients included other disease sites, lymphovascular invasion in the primary tumor, histopathological findings of the primary tumor and retroperitoneal disease, clinical and pathological stage, disease side and the specific site of anatomical involvement of metastatic disease within the spermatic cord specimen, that is spermatic vessels and/or surrounding lymphatic tissue. RESULTS: Of these 34 positive spermatic cord specimens 18 were in primary retroperitoneal lymph node dissections and 16 were in post-chemotherapy specimens. Histopathological evaluation in 25 (74%) and 9 (26%) of the 34 primary tumors showed a mixed germ cell pattern and pure embryonal carcinoma, respectively. Similarly 9 of the 34 retroperitoneal lymph node specimens (26%) showed pure embryonal cell carcinoma and the remainder showed mixed histopathological findings. Disease was clinical stage I in 13 cases (38%) and lymphovascular invasion was absent in the primary tumor in 11 (32%). Despite disease in the spermatic cord specimen there was none at the primary landing zone in 2 patients (6%), including 1 in whom the spermatic cord was the only disease site. In 12 positive spermatic cord specimens (35%) disease was identified in the surrounding perivascular and lymphatic tissue without gonadal vessel involvement. CONCLUSIONS: Metastatic disease in the spermatic vessels and/or surrounding lymphatic tissue represents a possible site of recurrence when incompletely excised. The lack of lymphovascular invasion in the primary tumor does not preclude metastatic disease in the spermatic cord specimen. Complete and wide excision of the spermatic cord and surrounding lymphatic tissues at retroperitoneal lymph node dissection is necessary and may prevent paracolic recurrence.     

Successful excision of an isolated mediastinal cystic lymphangioma with bilateral thoracoscopic surgery

Lymphangioma is a well-known benign tumor and its cystic abnormalities of the lymph vessels are predominantly congenital. Cystic lymphangioma usually occurs in the neck, axillary region, and rarely in the mediastinum, which frequently occurs in children and young adults. A 20-year-old woman had symptoms of palpitation, cough, and dyspnea during the recent 1 month. Both chest comuted tomography and magnetic resonance imaging of the chest revealed a well-defined, 13 × 10-cm cystic lesion in the anterior mediastinum. The patient underwent bilateral video-assisted thoracoscopic excision of the cyst and lymphangioma was confirmed based on histopathologic examination. Here, we report a rare case of isolated mediastinal cystic lymphangioma that was successfully excised using a minimally invasive technique.     

精索多形性脂肪肉瘤1例报告并文献复习

目的：分析并总结精索脂肪肉瘤患者的临床表现及其诊断及治疗方法。方法：回顾性分析我院收治的1例精索脂肪肉瘤患者的临床资料：左侧阴囊内有-9．0cm×9．4cm×6．7cm肿块,B超检查示左侧阴囊内存在一非均质实性包块;MRI显示左侧阴囊内有实质性肿瘤,未见肿大淋巴结。血清肿瘤标志物13-HCG、CEA、PSA和AFP检查均无异常。手术切除肿瘤的同时行左侧阴囊部分切除术。结果：术后病理检查提示为多形性混合型脂肪肉瘤。患者术后恢复顺利。结论：精索脂肪肉瘤是一种罕见的泌尿生殖系肿瘤,诊断主要依据病理检查结果确定;治疗以根治性睾丸切除术为主要方式,辅助放疗、化疗疗效不确切;预后与肿瘤组织病理类型密切相关,局部复发很常见,需长期随访。     

Malignant fibrous histiocytoma of the spermatic cord: the role of retroperitoneal lymphadenectomy in management

Malignant fibrous histiocytoma of the spermatic cord is rare, with only 6 previously reported cases. We describe 2 new cases that were treated with retroperitoneal lymphadenectomy. To our knowledge, this is the first report in the literature of retroperitoneal lymphadenectomy for the treatment of this specific lesion. The literature is reviewed in regard to the sarcomatous nature of this tumor and the use of retroperitoneal lymphadenectomy performed for spermatic cord sarcomas. We conclude that this procedure should be considered strongly as a surgical adjunct to wide local excision in the management of this unusual tumor.