本文選題：淋巴管瘤 + 腹部�。� 參考：《現(xiàn)代腫瘤醫(yī)學(xué)》2016年11期

【摘要】：目的:對(duì)成人腹部淋巴管瘤的臨床資料、CT表現(xiàn)進(jìn)行分析,結(jié)合文獻(xiàn)對(duì)其進(jìn)行總結(jié)、討論,以提高其術(shù)前診斷正確率。方法:回顧性分析5例經(jīng)手術(shù)病理證實(shí)的罕見腹部淋巴管瘤的CT表現(xiàn)及臨床資料,總結(jié)其診治要點(diǎn)。結(jié)果:5例病變中,女性4例,男性1例,發(fā)病年齡37~59歲(平均51.6歲)。2例患者無明顯臨床癥狀而在體檢時(shí)發(fā)現(xiàn),其余3例均以腹部包塊伴或不伴腹痛、腹脹為首發(fā)癥狀。3例患者存在腹部手術(shù)史,2例分別伴有外傷及輸血史。病變體積均較大,最大徑從4.3~33cm不等。呈爬行性或塑形生長(zhǎng),邊界尚清,表現(xiàn)為不同程度的占位效應(yīng)致使臨近組織結(jié)構(gòu)受壓移位。病變呈囊性者2例;囊實(shí)性者1例,其內(nèi)可見線樣鈣化影;實(shí)質(zhì)性者2例,病變周圍可見清晰的包膜結(jié)構(gòu)環(huán)繞。增強(qiáng)掃描病變部分示病灶囊壁及包膜輕度強(qiáng)化,部分病灶未見明顯強(qiáng)化成分。病理證實(shí)4例為囊性淋巴管瘤,1例為海綿狀淋巴管瘤,其中1例來源于脾臟,3例位于腹腔,1例位于腹膜后。確診后均經(jīng)手術(shù)完整切除,術(shù)后3年未見復(fù)發(fā)。結(jié)論:淋巴管瘤是成人腹部極少見的占位性病變,CT平掃及增強(qiáng)檢查能夠提供較多的診斷信息,根據(jù)其CT圖像及臨床資料特點(diǎn),尤其是當(dāng)患者有明確手術(shù)及外傷史,且病變?yōu)槟倚圆⒊?爬行性生長(zhǎng)"、臨床出現(xiàn)巨大占位與輕微占位效應(yīng)不相稱時(shí),首先考慮囊性淋巴管瘤的診斷,并在與腹部其他病變甄別后常可做出正確診斷。
[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.
【作者單位】： 西安交通大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院影像科;
【分類號(hào)】：R735;R730.44

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