少见成人腹部淋巴管瘤的CT表现及临床特点

发布时间：2018-06-16 16:02

本文选题：淋巴管瘤 + 腹部　；参考：《现代肿瘤医学》2016年11期

【摘要】：目的:对成人腹部淋巴管瘤的临床资料、CT表现进行分析,结合文献对其进行总结、讨论,以提高其术前诊断正确率。方法:回顾性分析5例经手术病理证实的罕见腹部淋巴管瘤的CT表现及临床资料,总结其诊治要点。结果:5例病变中,女性4例,男性1例,发病年龄37~59岁(平均51.6岁)。2例患者无明显临床症状而在体检时发现,其余3例均以腹部包块伴或不伴腹痛、腹胀为首发症状。3例患者存在腹部手术史,2例分别伴有外伤及输血史。病变体积均较大,最大径从4.3~33cm不等。呈爬行性或塑形生长,边界尚清,表现为不同程度的占位效应致使临近组织结构受压移位。病变呈囊性者2例;囊实性者1例,其内可见线样钙化影;实质性者2例,病变周围可见清晰的包膜结构环绕。增强扫描病变部分示病灶囊壁及包膜轻度强化,部分病灶未见明显强化成分。病理证实4例为囊性淋巴管瘤,1例为海绵状淋巴管瘤,其中1例来源于脾脏,3例位于腹腔,1例位于腹膜后。确诊后均经手术完整切除,术后3年未见复发。结论:淋巴管瘤是成人腹部极少见的占位性病变,CT平扫及增强检查能够提供较多的诊断信息,根据其CT图像及临床资料特点,尤其是当患者有明确手术及外伤史,且病变为囊性并呈"爬行性生长"、临床出现巨大占位与轻微占位效应不相称时,首先考虑囊性淋巴管瘤的诊断,并在与腹部其他病变甄别后常可做出正确诊断。
[Abstract]:Objective: to analyze the CT findings of abdominal lymphangioma in adults, summarize and discuss it in combination with literature to improve the accuracy of preoperative diagnosis. Methods: Ct findings and clinical data of 5 cases of rare abdominal lymphangioma confirmed by operation and pathology were analyzed retrospectively and the main points of diagnosis and treatment were summarized. Results of the 5 cases, 4 cases were female and 1 case was male. The age of onset was 3759 years old (mean 51.6 years old) without obvious clinical symptoms. The other 3 cases were found to have abdominal mass with or without abdominal pain. Abdominal distension was the first symptom in 3 cases. 2 cases had abdominal operation history and 2 cases had history of trauma and blood transfusion. The size of the lesion was large, and the maximum diameter varied from 4.3~33cm. It was creeping or plastic, and the boundary was still clear, which resulted in the compression displacement of the adjacent tissue structure due to different degree of space occupying effect. The lesions were cystic in 2 cases, cystic in 1 case, linear calcification in 2 cases and solid in 2 cases. Some of the lesions showed slight enhancement of the cyst wall and capsule, but no obvious enhancement components were found in some lesions. Pathologically, 4 cases were diagnosed as cystic lymphangioma and 1 case as spongiform lymphangioma, of which 1 case originated from spleen and 3 cases were located in abdominal cavity. 1 case was located in retroperitoneal cavity. After diagnosis, all patients underwent complete resection, and no recurrence occurred 3 years after operation. Conclusion: lymphangioma is a space occupying lesion rarely seen in adult abdomen. Ct plain scan and contrast enhancement can provide more diagnostic information. According to its CT image and clinical data, especially if the patient has a clear history of surgery and trauma, And the lesion is cystic and "crawling growth". When the large occupying space is not matched with the slight locus occupying effect, the diagnosis of cystic lymphangioma is considered first, and the correct diagnosis can be made after discriminating with other abdominal lesions.
【作者单位】：西安交通大学医学院第一附属医院影像科;
【分类号】：R735;R730.44

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