腹膜后囊性占位诊疗体会及文献复习(附3例报告)

目的:提高对腹膜后囊性占位的认识、诊治经验。方法:对收治3例腹膜后疑难囊肿的临床资料、诊治过程进行总结,并结合相关文献对其诊断及治疗进行探讨。结果:3例患者术前诊断分别为肾囊肿、2例腹膜后囊肿,2例通过腹腔镜下囊肿去顶减压术,1例通过开放性手术行去顶减压术。术后病理诊断为胰腺囊肿、淋巴管瘤性囊肿、肾上腺囊肿。术后随访6个月~2年未见复发。结论:腹膜后囊肿大多为良性疾病,早期临床症状不明显,随着囊肿体积增大压迫周围组织、器官出现相应的症状、体征,超声检查容易早期发现,在囊肿体积较小CT、磁共振检查更有利于明确囊肿来源及性质。     

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。     

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。     

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。     

机器人辅助腹腔镜切除盆腔表皮样囊肿1例报告并文献复习

目的:结合文献探讨腹膜后表皮样囊肿的诊治方法,介绍机器人辅助腹腔镜切除盆腔腹膜后巨大肿瘤的手术经验。方法:为1例青年男性盆腔腹膜后巨大肿瘤患者行机器人辅助腹腔镜手术切除,并结合文献探讨腹膜后表皮样囊肿的诊治方法。结果:患者行机器人辅助腹腔镜下表皮样囊肿切除术,手术完整切除肿瘤,手术时间1.5 h、出血量约8 ml。术后病理诊断为表皮样囊肿。术后1周出院,随访8个月未见囊肿复发及转移。结论:腹膜后表皮样囊肿在临床症状上缺乏特异性,需要与脊索瘤、畸胎瘤等相鉴别;因有感染、恶变的倾向,治疗上应手术切除。机器人辅助腹腔镜手术治疗位于盆腔的腹膜后巨大肿瘤具有良好的适应性。     

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。     

腹膜后巨大海绵状淋巴管瘤的手术治疗一例并文献复习

目的探讨对腹膜后巨大海绵状淋巴管瘤手术治疗方法的认识,提高治疗水平。方法回顾性分析1例成人腹膜后巨大海绵状淋巴管瘤的手术治疗过程,并结合文献复习讨论。结果腹膜后巨大海绵状淋巴管瘤完整切除,手术顺利,术后恢复好,未发生任何手术并发症。结论手术切除腹膜后巨大海绵状淋巴管瘤,需熟悉局部解剖关系,妥善保护周围组织,结扎离断与肿物相连的筋膜、淋巴管和血管组织,完整切除肿瘤,术后充分引流。     

肾上腺淋巴管瘤的诊断和治疗

目的：探讨肾上腺淋巴管瘤的临床表现、诊断及治疗方法。方法：回顾性分析本院12例肾上腺淋巴管瘤患者的临床资料,结合文献对其临床及病理表现、影像学特征及治疗情况进行探讨分析。结果：12例患者均行肿瘤切除术,其中3例行开放手术,6例行经腹腔途径腹腔镜手术,3例行腹膜后腹腔镜手术,术后均恢复良好;病理证实7例为肾上腺淋巴管瘤,5例为肾上腺血管淋巴管瘤;随访11个月～12年9个月,肿瘤无转移和复发。结论：肾上腺淋巴管瘤是一种极为罕见的肾上腺良性肿瘤,患者多无临床症状,部分患者有心悸、出汗、血压升高、腰痛等症状,术前影像学检查可提示诊断,病理检查可确定诊断。手术为首选治疗方法,预后较好。     

腹膜后淋巴管瘤诊治分析

腹膜后淋巴管瘤临床少见，加之腹膜后部位深、间隙大，临床又无特征性表现，确诊困难。当肿块增大到一定程度对周围组织或脏器产生占位压迫症状而就诊，往往诊断为腹膜后其它肿瘤行手术切除，经病理检查才得以确诊。我科20年来共收治腹膜后肿瘤55例，经手术切除病理确诊为腹膜后淋巴管瘤9例。术前无一例明确诊断为腹膜后淋巴管瘤。     

Urethral obstruction owing to retroperitoneal cystic lymphangioma

We report a case of cystic lymphangioma arising from retroperitoneal tissues of the pelvis, which caused urethral obstruction and eventual urinary retention. Sonography and computerized tomography demonstrated a retroperitoneal cystic mass in the pelvis. A preoperative diagnosis of retroperitoneal cystic lymphangioma was suggested by typical computerized and sonographic features.     

Retroperitoneal Cystic Lymphangioma

An interesting and rare differential diagnosis for a retroperitoneal cystic mass is cystic lymphangioma. A case of a patient presenting with a multicystic mass in the retroperitoneum that was identified as a cystic lymphangioma is reported. These tumours are commonly confused with other cystic masses in the retroperitoneum.     

肾上腺淋巴管瘤1例报告并文献复习

目的：探讨肾上腺淋巴管瘤的临床特点、诊断、髂别诊断、治疗及预后。方法：回顾性分析1例。肾上腺囊性淋巴管瘤的临床资料．复习相关文献并总结诊疗经验。结果：患者行腹腔镜下行左肾上腺切除术·未发生任何术中及术后并发症,术后恢复良好。结论：肾上腺淋巴管瘤是一种极为罕见的肾上腺良性肿瘤·患者一般无明显临床表现。术前诊断主要依靠影像学检查．确诊需病理学检查．手术治疗为首选方法。     

Ultrasonography with contrast agent for diagnosis of benign retroperitoneal cyst. Case report

Intraabdominal tumors require precise diagnosis for patient preparation for optimal surgical procedure. For diagnosis of these lesions, the principal studies used are ultrasonography, computed axial tomography (CAT) and occasionally the use of magnetic resonance imaging, a study not always possible to accomplish in all hospitals. We present the case of a patient with a giant retroperitoneal cyst whose diagnosis was missed by means of conventional ultrasound and CAT. For this reason, we chose to use ultrasound with echography using contrast agent (Levovist) to determine if the tumor was dependent on the liver or pancreas. By means of this technique, we were able to make the diagnosis that the tumor did not depend on any organ, but rather was an independent retroperitoneal tumor. Final surgical and histopathological diagnosis was a retroperitoneal multilocular lymphangioma. We conclude that ultrasonography with contrast agent (Levovist) is an alternative method for studying intraabdominal tumors.     

Infected retroperitoneal cystic lymphangioma masquerading as psoas abscess

A 2-year-old male is described who presented with fever, fixed flexion deformity of the right hip and a tender mass in the right iliac fossa. A clinical diagnosis of psoas abscess was made. Abdominal ultrasound was suggestive of an echogenic retroperitoneal cyst but could not accurately determine the nature of the cyst. A contrast CT scan showed a retroperitoneal cyst. At laparotomy, a large retroperitoneal cyst containing turbid fluid was found and was excised completely. Histopathological examination was suggestive of cystic lymphangioma. Clinical presentation of retroperitoneal lymphangioma may be variable and misleading, therefore complex imaging studies are necessary in the evaluation of this condition.     

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.     

成人腹膜后淋巴管瘤八例分析

目的探讨成人腹膜后淋巴管瘤的诊断和治疗。方法回顾性分析我院自1995年8月至20（18年3月收治并经病理学检查证实的成人腹膜后淋巴管瘤8例的临床资料。结果本组均行手术治疗。其中,行完整切除6例,行大部分切除2例。术后随访未见肿瘤复发。结论腹膜后淋巴管瘤临床表现缺乏特异性,术前难确诊,CT等影像学检查对该病的定性、定位具有一定的提示性。手术切除是该病的首选治疗方法。     

A case of primary retroperitoneal mucinous cystadenocarcinoma

A 41-year-old Japanese woman was admitted to our hospital for right abdominal mass. Various examinations revealed a retroperitoneal lymphangioma. Tumor resection was performed and pathological diagnosis was a mucinous cystadenocarcinoma. It seems that screening with the tumor markers will be helpful for the diagnosis, because it is very difficult to diagnose a retroperitoneal mucinous cystadenocarcinoma before the operation.     

腹膜后淋巴管瘤的诊断与治疗

腹膜后囊性淋巴管瘤临床少见，这是一种淋巴管畸形或发育障碍所致的疾病。作者近２０年间收治６例。首发症状为腹部肿块及消化道功能障碍。术前确诊仅１例，其余误诊为胰腺囊肿，畸胎瘤及卵巢囊肿。６例均行手术治疗，单纯囊肿切除３例，囊肿大部分切除２例，囊肿并胰尾切除１例。手术均获成功。术后随访１～１９年，均未复发。作者认为，Ｂ超、ＣＴ对此病的诊断有重要意义，手术切除是目前治疗本病的理想方法。