Intra-abdominal cystic lymphangioma

Cystic lymphangioma is an uncommon intra-abdominal lesion that is an occasional incidental finding. We report herein the case of a 27-year-old woman with a 3-year history of abdominal pain due to a large intra-abdominal cystic lymphangioma. The lesion was removed surgically with a complete resection that is the optimal treatment with excellent prognosis.     

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.     

The association of jejunal atresia and cystic lymphangioma in the same location

Cystic lymphangiomas, which are localized on the mesentery of the intestine, are rarely seen. The presence of intestinal atresia together with cystic lymphangioma in the same location has never been described before. In this study, a premature girl weighing 2,630 g who had jejunal atresia, cystic lymphangioma localized in the mesentery of the distal atretic jejunal segment, and multiple rib anomalies is presented. The association of jejunal atresia and cystic lymphangioma may be coincidental, or jejunal atresia may be caused by an intrauterine vascular compression of volvuled cystic lymphangioma. Such an association is being reported for the first time in the literature.     

肾上腺淋巴管瘤的诊治分析

总结分析17例肾上腺淋巴管瘤的临床诊治经验,探讨该病的影像特点及病理类型。结果显示,肾上腺淋巴管瘤的影像学检查无特异性,表现与一般的囊肿相似,但囊腔密度略高于单纯性囊肿,部分病例囊壁可见钙化,少数可显示腺瘤样表现。本病确诊主要靠病理检查。对于肿瘤最大径≥4.0 cm、有内分泌功能、可疑恶性,或有明显临床症状者,推荐手术...     

Laparoscopic resection of a retroperitoneal cystic lymphangioma

The success of laparoscopic cholecystectomy has expanded the scope of laparoscopic procedures and resection of retroperitoneal organs and selected cystic intraadominal masses have been performed by minimally invasive surgical techniques. We report the case of a 45-year-old that presented a retroperitoneal cystic lymphangioma that was successfully excised by a laparoscopic approach. Laparoscopic surgical techniques should be considered for treatment of selected cystic lesions of intrabdominal or retroperitoneal origin.     

胰腺囊性肿瘤的临床诊治

提高对胰腺囊性肿瘤诊断和治疗的认识,减少这种少见肿瘤的误诊误治。方法:对1958年4月～1995年7月经病理证实的15例胰腺囊性肿瘤病人进行回顾性分析。结果:15例胰腺囊性肿瘤中,浆液性囊腺瘤6例,粘液性囊性肿瘤9例。肿瘤位于胰头部4例,体尾部10例,全胰1例。15例病人全部进行手术治疗,其中12例获手术切除,切除率为80％。术前明确诊断为胰腺囊性肿瘤者仅6例,其余9例术前被误诊为胰腺假性囊肿或中、上腹肿块而行手术,其中7例术中被诊为囊性肿瘤而获相应的根治性切除,另2例被错误地进行了内引流术。结论:胰腺囊性肿瘤临床上常被误诊,只要综合运用病史分析、影像学特点、囊液分析、术中活检等方法,就能提高诊断的准确率。胰腺囊性肿瘤手术切除率高,预后较好。     

An unusual case of a large cystic swelling in thigh: cystic lymphangioma in an adult

Cystic lymphangioma is a rare congenital malformation found almost exclusively in the pediatric age group. Approximately 100 adult cases have been reported in the literature, mostly in the head and neck region. Trauma has been suggested as a possible etiology in the development of such lesions in adults. We report a case of cystic lymphangioma in the lower limb of an adult, which is so far the largest one reported and may support this theory. The patient developed the lesion after sustaining trauma to the left thigh in a road traffic accident. It subsequently progressed to a massive size over 20 years. The histopathology of the excised lesion showed evidence of an organized hematoma supporting the theory of trauma as a likely etiology in the development of these lesions in adults. A relevant review of the literature is also presented.     

Cystic lymphangioma of the lesser omentum in an adult

Abdominal lymphangiomas are uncommon congenital benign tumors that occur mainly in children. The authors report the case of a 37-year-old woman with a cystic lymphangioma of the lesser omentum. The lesion was removed surgically with a complete resection. The histologic diagnosis was omental lymphangioma. Complete surgical resection with negative surgical margins is the treatment of choice, and the results are excellent. Incomplete resection may lead to recurrence.     

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。     

小胃肠道间质瘤的诊断和治疗策略

长期以来胃肠道间质瘤(GIST)的实际发病率常被低估.随着对这一疾病的认识和检查技术的进步,小GIST患者(直径＜5 cm)的检出率逐年升高.该类患者多无明显临床症状,常在体格检查被意外发现.对于这类患者的诊断需要联合内镜和CT检查.在明确诊断的基础上,对直径t≥2 cm的小GIST患者应积极行肿瘤的完整切除术,而目前腹腔镜手术逐渐成为治疗的标准术式.对于直径＜2 cm的微小GIST,特别是微小胃间质瘤,目前的指南推荐可以行密切随访,有学者提倡内镜切除肿瘤.笔者认为应当谨慎鉴别小GIST恶性潜能而后选择个体化治疗策略.     

A case of a giant cystic lymphangioma mimicking acute appendicitis

Cystic lymphangiomas are rare tumours that can mimic various causes of acute abdomen including appendicitis. They exhibit variations in two characteristics on presentation: they can arise from a wide range of organs including various intra-abdominal structures and they can have a wide variation in size on presentation. We report a case of a gigantic cystic lymphangioma presenting as an acute abdomen closely mimicking acute appendicitis and we conduct a review of the relevant literature.     

Cystic lymphangioma confined to mediastinum in an adult

Mediastinal lymphangiomas are very rare tumors among the slow-growing mediastinal masses in the literature. We present the successful resection of a 52-year-old woman who was referred to our hospital. Past medical history consisted of surgical treatment for cervical mass and pathological diagnosis of lymphoma nine years earlier. She underwent postoperative radiotherapy. Preoperative chest roentgenogram and computed tomogram of the chest showed a cystic mass in the anterior mediastinum. The tumor was completely resected. The preoperative diagnosis was never questioned until the histopathological examination confirmed that the lesion was a cystic lymphangioma. Cystic lymphangiomas are benign tumors with the evidence of progression in tumor size and invasion into the vital structures. As our case shows, the tumor involvement with the vital structures causes difficulty in removal.     

Postoperative chylothorax following partial resection of mediastinal lymphangioma: Report of a case

We report herein the rare case of a 20-year-old man in whom a mediastinal lymphangioma was incidentally detected by a chest roentgenogram taken during a routine health examination. Both computed tomography and magnetic resonance imaging confirmed a mass measuring 3×7 cm in diameter in the left anterior mediastinum. A thoracoscopic exploration was done, which confirmed a diagnosis of mediastinal lymphangioma, and 3 days later a sternotomy was performed. However, the tumor could not be completely extirpated due to partial invasion. Following the thoracoscopic procedure, a chylous discharge developed which was difficult to treat conservatively and he continued to drain 700–1,000 ml of chyle daily 2 weeks following the tumor extirpation. Therefore, a right thoracotomy with ligation of the thoracic duct was performed which resolved the chylothorax. The patient remains well without any regrowth of the regional tumor 9 months after his operation.     

Thoracoscopic resection of a solitary pulmonary lymphangioma: Report of a case

We present herein the rare case of a young man who was found to have a solitary tumor in the right upper lobe of his lung by a routine chest X-ray. The tumor was removed by thoracoscopic surgery, and pathological examinations confirmed the diagnosis of a primary lymphangioma of the lung. A brief review of the available literature on this extremely rare type of benign tumor follows the case report.     

胰腺囊性肿瘤诊治中的常见问题(附25例报告)

目的：分析和解决胰腺囊性肿瘤诊治中的常见问题。方法：回顾分析了1984-2002年中25例胰腺囊性肿瘤的诊治资料。结果：既往曾被误诊为假性囊肿而作囊肠或胃吻合11例，误诊率44.0%；手术切除率68.0%；除3例浆液性囊腺瘤外，其余22例中恶性占68.2%；随访22例，半数以上病人生存3年多，其中8例仍健在。结论：提高对胰腺囊性肿瘤的认识，减少误诊和积极的手术切除是改善其预后的主要措施。     

原发性骶前肿瘤的诊断与治疗

为探讨骶前肿瘤的诊断与治疗，分析了３７例骶前肿瘤的诊断和治疗情况。肿瘤直径３～１６ｃｍ。术前诊断主要依靠直肠指诊、Ｂ超、ＣＴ等相关检查。手术方法有：经骶尾部切除１５例，经腹切除１０例，经腹尾部联合入路切除６例。其中合并切除直肠４例，肿瘤完整切除２１例，部分切除１０例，未切除６例，切除率８３．８％。并发症有出血、直肠损伤、术后骶前感染、脓肿形成。作者认为合理选择手术径路、手术方式是切除肿瘤的关键。术前影像学检查对肿瘤定位和术式选择有重要意义     

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。     

Lymphangioma of the kidney

Lymphangiomas are rare benign tumors that are congenital malformations of the lymphatic system. Most cases present in children as a soft, cystic mass in the neck and the axilla. Primary renal lymphangioma is exceedingly rare, with only 35 cases reported so far. We report a case of primary lymphangioma arising from the kidney. A 59-year-old man was referred for evaluation of a right renal mass found in an abdominal ultrasonography during a health checkup. Abdominal ultrasonography and computed tomography (CT) revealed a 3.2 x 2.9 cm multiloculated cystic mass in the upper pole of the right kidney. We could not deny malignant disease such as cystic renal cell carcinoma with any diagnostic modalities. The patient was brought to surgery. During the surgical procedure, the tumor was suspected to be lymphangioma of the kidney as a result of a frozen- section histopathological evaluation. Therefore enucleation of the tumor was performed. Pathological evaluation of the specimen revealed lymphangioma arising from the kidney. The patient is free of disease after a 3-month follow-up period.