Treatment of lymphangioma in children: our experience of 128 cases

Purpose

The aim of this study is to investigate the optimal treatment for lymphangioma in children by analyzing the effectiveness and complications of treatment modalities.

Methods

We reviewed 128 patients with lymphangioma treated at our institution between 1979 and 2005. Periods of treatment were divided arbitrarily into 2 groups: period I, from 1979 to 1988 (n = 53); and period II, from 1989 to 2005 (n = 75). According to radiological appearance, patients were grouped into 4 types: single cystic (SI; n = 23), macrocystic (MA; n = 11), microcystic (MI; n = 69), and cavernous (CA; n = 25).

Results

Sclerotherapy as primary treatment was performed in only 2 patients (3.8%) in period I using bleomycin but increased significantly in period II to 48 patients (64.0%) using OK-432 (P < .01). Nevertheless, primary surgical excision (69/78 patients, 88.5%) was significantly more successful than sclerotherapy (32/50, 64.0%) (P < .01). The following are the locations and types of lesions: head/neck (n = 69; SI, 11; MA, 5; MI, 42; CA, 11), trunk (n = 34; SI, 6; MA, 6; MI, 15; CA, 7), and extremities/other (n = 25; SI, 6; MI, 12; CA, 7). The effectiveness of sclerotherapy in SI, MA, MI, and CA types was 90.9%, 100%, 68.0%, and 10.0%, respectively. Seventeen patients (SI, 1; MI, 8; CA, 8) who received primary sclerotherapy required surgical excision with good outcome. Complications after primary surgical excision were more serious compared with sclerotherapy.

Conclusion

Sclerotherapy with OK-432 was not as effective as reported in the literature. We recommend OK-432 injection therapy alone for SI and MA types and surgical excision after pretreatment with OK-432 for MI and CA types.     

Gastrointestinal tract lymphangiomas: findings at CT and endoscopic imaging with histopathologic correlation

Objective  To evaluate and describe CT and endoscopic imaging findings in patients with pathologically confirmed gastrointestinal tract lymphangiomas. Methods  Findings from imaging examinations in 6 patients with pathologically confirmed lymphangioma were retrospectively reviewed (computed tomographic images obtained in 6 patients and endoscopic images obtained in 4 patients were available for review). Two radiologists evaluated lesion location, size, shape, edge, number, attenuation, the thickness of capsule wall and the degree of enhancement through PACS or workstation. Results  Lymphangiomas in gastrointestinal tract showed similar features in CT imaging: Contrast-enhanced CT scan showed the oval submucosal masses with homogeneous low attenuation. The lymphangioma appeared as a well-defined, smoothly marginated and non-enhancing cystic mass with intact overlying intestinal mucosa. In one case, the lymphangiomas were multiple with volvulus. Remarkably, CT imaging showed 2 patients with intussusception due to the mass. Endoscopic photographs manifested multiple colplanate mucosal protrusions in the gastric wall or intestinal wall. One case showed submucosal pedunculated proliferative lesion with adenomatous surface. Conclusions  Lymphangiomas exhibited typical appearances that reflected their cystic pathologic features. They showed similar features in CT imaging: well-demarcated, non-enhancing, homogeneous low attenuation cystic masses with intact overlying mucosa. Endoscopic photographs showed submucosal masses with distension of overlying mucosal vessels.     

药物局部注射治疗小儿血管瘤临床观察

目的观察药物局部注射治疗小儿体表血管瘤的临床效果。方法回顾性分析1992年至2008年我院药物局部注射治疗小儿血管瘤916（瘤体974个）例的选药、方法及疗效。结果显效586例,有效325例,无效63例。发生并发症57例。经1年以上随访,93．4％（910／974）的血管瘤完全消退。结论应用药物局部注射治疗小儿血管瘤,方法简单,疗效显著,且较其他方法外观效果佳。本法可作为治疗小儿血管瘤的临床首选。     

骨缺损修复材料的研究进展

在骨缺损修复治疗中,需要植入骨支架材料以恢复损伤处相应的组织结构.目前,用于骨缺损的修复材料主要有自体骨、同种异体骨、金属材料、生物陶瓷、高分子材料及各种复合材料.不同材料在骨修复中均展示出强大的重建能力,然而临床中理想的骨植入物依然较少,水平参差不齐,除自体骨外,其他材料用于骨缺损修复中尚无法同时具备良好的生物相容性...     

成人胃肠道囊性淋巴管瘤的CT表现

目的：探讨成人胃肠道囊性淋巴管瘤的CT表现及其诊断价值。方法回顾性分析经病理证实的5例成人胃肠道囊性淋巴管瘤患者的CT表现,并与手术和病理结果进行对照。结果5例患者中,3例单发、2例多发;发生于胃壁1例,十二指肠1例,回肠1例,回肠伴肠系膜多发病灶1例,回肠、结肠伴腹膜后多发病灶1例;病灶大小为2.4~23.7 cm;其中4例病灶呈匍行生长趋势,伸入组织间隙;5例病灶均呈水样低密度囊性病灶,边界清晰,增强后均未见强化。结论胃肠道囊性淋巴管瘤多为单房囊腔,呈匍行生长,内含均匀液性低密度影,囊壁边界清楚,囊壁及其内容物一般无强化,与其囊性病理学特征相符。     

淋巴管瘤的超声特征分析

目的探讨淋巴管瘤的二维及彩色多普勒声像图表现特征。方法回顾分析30例淋巴管瘤患者的声像图资料,与手术病理资料对比分析,总结其特点。结果根据淋巴管瘤的发生部位将其分为疏松间隙处17例,体表软组织处10例及内脏处3例;按其病理分型分为囊性淋巴管瘤18例和海绵状淋巴管瘤12例;根据超声表现分为囊肿型23例,囊实混合型5例,强回声型2例。结论不同病理分型的淋巴管瘤其发生部位和超声表现有一定差异。超声检查对大多数淋巴管瘤的定位及定性诊断具有重要价值。     

Bilateral lymphangiomatous polyps of the palatine tonsils

Lymphangiomatous polyps of the tonsils are rare with less than 30 cases reported in the literature. All have been unilateral. We report a case of a child with bilateral lymphangiomatous polyps of the palatine tonsils that was suspected on preoperative examination as opposed to an incidental postoperative histologic finding. These findings were also correlated with a further imaging study to establish this entity as a localized rather than a generalized histologic phenomenon.     

肾上腺囊性淋巴管瘤的CT诊断

目的 分析肾上腺囊性淋巴管瘤的CT特征. 资料与方法 回顾性分析了4例经手术病理证实的肾上腺囊性淋巴管瘤的CT表现,包括大小、形态、边界、构成、密度、钙化、间隔和增强方式. 结果 肾上腺囊性淋巴管瘤形态不规则;呈多囊结构,由许多大小不等的囊肿组成;间隔多且均匀一致,强化后明显;瘤体密度值偏高,无强化;钙化率高,局限于瘤壁和间隔. 结论 肾上腺囊性淋巴管瘤在形态、构成、间隔、钙化和密度等方面均有一定的特异性.应用多层螺旋CT增强扫描并进行三维重组有助于发现肾上腺囊性淋巴管瘤的CT特征并确立诊断.