子宫囊性淋巴管瘤1例并文献复习  

Clinical analysis of uterine cystic lymphangioma:a case report and literature review

作　　者：曾月[1,2] 蔡志福[1] 王鹤[1] 

机构地区：[1]广西医科大学附属肿瘤医院妇瘤科,南宁530021 [2]广西医科大学研究生学院,南宁530021

出　　处：《中国癌症防治杂志》2016年第5期304-307,共4页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：广西肿瘤学优势特色重点学科资助项目(024012002)

摘　　要：目的探讨子宫囊性淋巴管瘤的临床病理特征,提高临床医师对子宫囊性淋巴管瘤的认识。方法分析1例子宫囊性淋巴管瘤的临床表现、辅助检查、病理学特点、鉴别诊断及治疗,并进行相关文献复习。结果患者,女性,45岁,因"间歇性腹部胀痛2年,发现腹部肿块1年余"入院,结合入院相关检查,术前诊断为子宫肌瘤囊性变,行全子宫切除术。病理检查:子宫体前壁可见一囊性肿瘤,囊液呈淡黄色、清亮,囊内壁光滑,囊腔与子宫腔不通;镜下见囊壁内衬一层被覆单层扁平细胞,囊壁平滑肌间见淋巴网状结构,囊腔内见纤维蛋白物及少许淋巴细胞。免疫组化示D2-40阳性、CKpan弱阳性。术后病理诊断为子宫囊性淋巴管瘤。术后未行特殊治疗,随访6个月未见异常征象。结论子宫囊性淋巴管瘤少见,临床以阴道不规则流血及盆腔包块多见,影像学无特异性表现,血清肿瘤标志物水平不升高,治疗以手术为主,确诊需要根据术后组织病理学及免疫组化检查。To explore the clinical pathological features of uterine cystic lymphangioma and promote proper understanding among clinical gynecologists. Methods Clinical manifestations,auxiliary examinations,imaging outcomes,differential diagnosis and treatment of a case of uterine cystic lymphangioma were analyzed,and related literature was reviewed. Results We report the case of a 45-year-old woman hospitalized for intermittent abdominal pain and an abdominal mass. On the basis of these factors,combined with relevant auxiliary examinations,the patient was diagnosed with uterine fibroid cystic change before the operation.The patient was treated by total hysterectomy,a cystic mass arising from the anterior uterine wall,and clear yellow fluid filled the cyst,while the interior uterine wall is smooth,the uterine cavity is not connected with the cyst. The capsule wall of the tumor was composed of simple squamous cell,lymphatic network structure was obsersed in the smooth muscle of the cystic wall,chamber fibrin content and a few lymphocytes were also observed. D2-40 was positive,CKpan was weakly positive. The pathological diagnosis was uterus cystic lymphangioma. No special treatment was given after surgery,there was no recurrence at the follow-up of 6 months. Conclusion Uterine adenomyoma cysts are extremely rare and are characterized by abnormal vaginal bleeding and pelvic mass. No features are visible by imaging,serum tumor markers are usually not elevated,and the disease is easily misdiagnosed. Surgery is the treatment of choice,and pathology and immunohistology tests helps to confirm the diagnosis.

关 键 词：子宫肿瘤 囊性淋巴管瘤 子宫肌瘤囊性变 误诊 

分 类 号：R737.33[医药卫生—肿瘤]