成人肠系膜淋巴管瘤16例临床分析  

Diagnosis and treatment of mesenteric lymphangioma in adults: report of 16 cases

作　　者：肖刚[1] 于宏[1] 于晓鹏[1] 王越市 夏慧霞 刘艳梅 陈更 张震 XIAO Gang1, YU Hong1, YU Xiao-peng1, WANG Yue-shi1, XIA Hui-xia1, LIU Yan-mei2, CHEN Geng1, ZHANG Zhen1(1.Second Department of General Surgery, 2.Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang 110004, Chin)

机构地区：[1]中国医科大学附属盛京医院第二普通外科,辽宁沈阳110004 [2]中国医科大学附属第一医院风湿免疫科,辽宁沈阳110004

出　　处：《中国现代普通外科进展》2018年第6期429-432,436,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨成人肠系膜淋巴管瘤的病因、临床表现、影像学特点及诊断和治疗方式。方法:回顾性分析我院2010年1月—2017年12月16例手术及病理证实的肠系膜淋巴管瘤患者的临床资料。结果:男9例,女7例,年龄19~72岁。患者中有症状10例(62.5%),表现为腹部包块合并腹痛或腹胀等症状;无症状6例(37.5%)。所有患者均行CT检查,其中5例(31.25%)考虑淋巴管瘤,11例(68.75%)例提示腹腔低密度囊性肿物或腹腔占位;部分病例行B超及MRI检查。6例(37.5%)患者术前诊断淋巴管瘤,所有患者均行手术治疗,7例(43.75%)腹腔镜下肿物切除,9例(56.25%)行剖腹探查+肿物切除。所有术后病理均诊断为肠系膜淋巴管瘤。1例患者术后出现切口感染,经治疗后好转。15例(93.75%)患者获访,1例(6.25%)失访,随访期间患者均未复发。结论:成人肠系膜淋巴管瘤为一种少见病,可能与先天性淋巴发育不良有关,且具有一定的侵袭性生长能力。术前CT和超声、MRI检查对该病的诊断有提示作用,但由术后病理活组织检查确诊。手术完全切除肿瘤是其主要的治疗方式,术后多无复发;不能手术的情况下可联合放化疗等综合治疗。Objective： To expore the etiology, clinical features, imaging findings, diagnosis and treatments of mesenteric lymphangioma in adults. Methods： We report a retrospective study from January 2010 to January 2018 concerning 16 patients who underwent surgical removal of mesentericlymphangioma confirmed by pathology, and review of literature. Results： The main clinical manifestations were abdominal painand distention found in 10 patients. Other patients didn’t have any symptoms. The total patients were examined by CT, and the results showed that it was low density cystic mass in the abdominal cavity. All patients underwent surgical treatment, including Laparoscopic resection of lymphangioma and exploratory. One patient’s wound was infected, and cured with antibiotics. The 15 patients had no recurrence during the follow-up period, and the 1 patient was not followed up. Conclusions： Adult mesenteric lymphangioma is a rare benign tumor that may be associated with congenital dysplasia. Preoperative ultrasonography, CT and MRI can improve the diagnostic rate of the disease. However, the accurate diagnosis and classification should rely on pathological examination.The tumor has the ability of invasion and growth, so that we recommend completely surgical excision is treatment of choice by laparoscopy or laparotomy to avoid recurrence.

关 键 词：肠系膜淋巴管瘤 诊断 治疗 

分 类 号：R735.4[医药卫生—肿瘤]