外阴获得性淋巴管瘤六例误诊分析  

Misdiagnosis Analysis of 6 Patients with Acquired Lymphangioma of the Vulva

作　　者：杨慧 崔静 苏丹妮 吕玲 刘思萌 姚玉芳 陈永国 YANG Hui;CUI Jing;SU Danni;LYU Ling;LIU Simeng;YAO Yufang;CHEN Yongguo(Department of Dermatology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院皮肤性病科,北京100049

出　　处：《临床误诊误治》2024年第3期29-32,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 探讨外阴获得性淋巴管瘤的临床表现、病理特点、诊断与鉴别诊断、误诊原因及防范措施。方法 回顾性分析2018年5月—2023年2月初诊误诊的外阴获得性淋巴管瘤6例的临床资料。结果 6例因大阴唇及大阴唇外侧皮肤表面有大小不等的充满液体水疱,部分水疱因摩擦后破裂,局部表现为鲜红色糜烂面就诊,病程3个月~4年。就诊初期误诊为尖锐湿疣3例、生殖器疱疹2例、血管角皮瘤1例,误诊时间2 d~5个月。后经组织病理学检查确定诊断为外阴获得性淋巴管瘤,均给予液氮冷冻治疗;术后随访6个月,2例复发,4例未复发。结论 外阴获得性淋巴管瘤发病率低,临床少见,组织病理学检查前易误诊。当患者因外阴水疱、丘疹、结节就诊时,临床医生应仔细询问病史、手术史,掌握疾病临床特点、诊断及鉴别诊断要点,及时行组织病理学检查,可减少外阴获得性淋巴管瘤早期误诊。Objective To investigate the clinical manifestations,pathological features,diagnosis and differential diagnosis,causes of misdiagnosis,and preventive measures of acquired lymphangioma of the vulva.Methods The clinical data of 6 patients with misdiagnosed acquired lymphangioma of the vulva admitted from May 2018 to February 2023 were retrospectively analyzed.Results Six patients were treated with fluid-filled blisters of varying sizes on the skin surface of the labia majora and the outer labia majora.Some of the blisters broke due to friction,and the local manifestations were bright red erosions.The course of disease was 3 months to 4 years.The initial misdiagnosis was condyloma acuminatum in 3 patients,genital herpes in 2 patients and angioceratoma in 1 patients.The misdiagnosis lasted 2 d to 5 months.After histopathological examination,the diagnosis was confirmed as acquired lymphangioma of the vulva,and liquid nitrogen freezing treatment was given.At 6-month follow-up,2 patients recurred and 4 patients did not.Conclusion The incidence of acquired lymphangioma of the vulva is low,and it is rare in clinical settings,which is,therefore,more prone to misdiagnosis before histopathological examination.When patients presented with vulvar blisters,papules and nodules,clinicians should carefully inquire about the medical history and surgical history,grasp the clinical characteristics of the disease,diagnosis and differential diagnosis,and perform timely histopathological examination,which can reduce the early misdiagnosis of acquired lymphangioma of the vulva.

关 键 词：外阴获得性淋巴管瘤 误诊 尖锐湿疣 生殖器疱疹 血管角皮瘤 冷冻疗法 诊断 鉴别诊断 

分 类 号：R733.4[医药卫生—肿瘤]