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Matsuo T, Tanaka T, Kimata Y. Decades of stability of conjunctival vascular malformations in two patients. Clin Case Rep 2024; 12:e8933. [PMID: 38741673 PMCID: PMC11089082 DOI: 10.1002/ccr3.8933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/14/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024] Open
Abstract
Key Clinical Message Conjunctival hemangioma and lymphangioma are rare and their long-term follow-up description has been scarce. In our two patients, conjunctival vascular and lymphatic malformations remained stable in decades and could be observed without treatment. Abstract A 65-year-old woman with diabetic retinopathy underwent glaucoma surgery to construct a filtering bleb adjacent to conjunctival hemangioma, and showed bleb function and stable hemangioma for a decade. A 1.5-year-old girl with right eye lid and cheek swelling by orbital to facial lymphangioma was followed for visual acuity development. Conjunctival lymphangioma was stable in 20 years.
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Affiliation(s)
- Toshihiko Matsuo
- Graduate School of Interdisciplinary Science and Engineering in Health SystemsOkayama UniversityOkayamaJapan
- Department of OphthalmologyOkayama University HospitalOkayamaJapan
| | - Takehiro Tanaka
- Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayama UniversityOkayamaJapan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayama UniversityOkayamaJapan
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2
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Chaouch E, Aydin S, Cristina Anca D. Unusually Hypervascularized Liver Lesion. J Belg Soc Radiol 2024; 108:45. [PMID: 38680725 PMCID: PMC11049680 DOI: 10.5334/jbsr.3576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/07/2024] [Indexed: 05/01/2024] Open
Abstract
Teaching point: Microcystic lymphangioma is a rare but benign lesion that should be differentiated from a neoplasm.
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3
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Zhang K, Dai W, Yu H, Shi Q, Xie S, Hu B, Li Q, Wei X. Multidisciplinary management and surgical resection of a rare posterior mediastinal haemangioma. J Surg Case Rep 2024; 2024:rjae225. [PMID: 38605697 PMCID: PMC11007634 DOI: 10.1093/jscr/rjae225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
Mediastinal haemangiomas pose diagnostic and therapeutic challenges owing to their rarity and complex anatomy. A 36-year-old man, with a history of smoking and drinking, presented with a posterior mediastinal mass with back pain. Initial investigations suggested a lymphangioma. However, owing to persistent symptoms and complex pathology, we performed surgical intervention involving open resection of the tumour, which was closely associated with the descending aorta and extended into the right posterior mediastinum. The surgical approach was influenced by the proximity of the tumour to vital structures, necessitating an open procedure. Postoperative complications included chylothorax, managed with a fat-free diet. The final pathological diagnosis was consistent with a benign vascular tumour with a low proliferative rate. Two months post-surgery, computed tomography revealed no complications, and the patient's pain had decreased. A multidisciplinary approach and surgical intervention played important roles in the diagnosis and treatment of this posterior mediastinal haemangioma.
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Affiliation(s)
- Kaixin Zhang
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Graduate School, Chengdu Medical College, Chengdu 610041, Sichuan, China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Hongfan Yu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - Qiuling Shi
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China, Chengdu 610041, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Shaohua Xie
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Bin Hu
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Xing Wei
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of China, Chengdu 610041, China
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4
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Ricardo Ossio GP, Gallo Orjuela DM, Salazar Agudelo J, Gonzalez Gomez C, Tenelanda Lopez D. Renal Lymphangiectasia: The Transcending of Serendipity. Cureus 2024; 16:e56669. [PMID: 38646391 PMCID: PMC11032696 DOI: 10.7759/cureus.56669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Renal lymphangiectasia, a rare entity of the renal lymphatic system affecting both genders and all ages, can manifest bilaterally or unilaterally and has been referred to by various terms, such as renal lymphangiomatosis, renal lymphangioma, and others. Distinguishing this condition from common pathologies, such as polycystic kidney disease or hydronephrosis, is crucial. This article presents an innovative clinical case of unilateral renal lymphangiectasia in a 67-year-old woman with a relevant medical history. Detection was achieved by ultrasound in primary care using the point-of-care ultrasound (POCUS) technique under the focused assessment with sonography in trauma (FAST) protocol, revealing findings suggestive of renal lymphangiomatosis. This case highlights the utility of advanced technologies, such as bedside ultrasound, in addressing and transforming the approach to rare medical conditions, offering a compelling reminder of the positive influence of technological innovation in clinical practice.
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Affiliation(s)
- Gina Paola Ricardo Ossio
- Medical Affairs, Universidad del Rosario, Bogota, COL
- Clinical Research, Universidad Metropolitana de Barranquilla, Barranquilla, COL
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Martínez-Doménech Á, Esteve-Martínez A, Pérez-Pastor G, Sánchez-Carazo JL, Pérez-Ferriols A. Lower limb lymphangioma circumscriptum: The guiding sign for the diagnosis of Maffucci syndrome. Australas J Dermatol 2024. [PMID: 38419154 DOI: 10.1111/ajd.14229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Affiliation(s)
| | - Altea Esteve-Martínez
- Department of Dermatology, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Gemma Pérez-Pastor
- Department of Dermatology, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | | | - Amparo Pérez-Ferriols
- Department of Dermatology, Consorci Hospital General Universitari de Valencia, Valencia, Spain
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Cinotti E, Barbarossa L, Cortonesi G, Lamberti A, La Marca F, Tognetti L, Rubegni P, Perrot JL. Non-Invasive Imaging for the Diagnosis of Genital Warts and Their Imitators. J Clin Med 2024; 13:1345. [PMID: 38592196 PMCID: PMC10932056 DOI: 10.3390/jcm13051345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Genital warts are the most frequent sexually transmitted disease. Their clinical diagnosis is not always easy, and invasive skin biopsies for histological examination should be performed in these cases. The aim of the study was to investigate the use of non-invasive imaging techniques for the diagnosis of genital warts and their imitators. We retrospectively evaluated dermoscopy, reflectance confocal microscopy (RCM), and line-filed confocal microscopy (LC-OCT) images of nine patients with 19 warts of the mucous membranes and five patients with lesions that clinically mimic genital warts, including 12 molluscum contagiosum, 1 Fordyce's spot and one case of multiple acquired lymphangiomas. Most genital warts (15; 79%) showed dilated vessels surrounded by a whitish halo at dermoscopy. RCM and the new device LC-OCT could identify near histologic features such as the presence of hyperkeratosis, acanthosis, papillomatosis and enlarged vessels in all genital warts. However, the identification of koilocytes, which are the hallmark for the diagnosis of warts, was still difficult using both techniques. Non-invasive imaging techniques could also offer clues for the correct diagnosis of the imitators. This study confirmed the usefulness of dermoscopy in recognizing a precise pattern in warts and showed the potential use of RCM and LC-OCT to add additional findings to the clinical and dermoscopic examination.
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Affiliation(s)
- Elisa Cinotti
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Lorenzo Barbarossa
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Giulio Cortonesi
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Arianna Lamberti
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Francesca La Marca
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Linda Tognetti
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Pietro Rubegni
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, 42100 Saint-Etienne, France;
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Klibngern H, Ariyanon T, Pornchaisakuldee C, Chowsilpa S, Sittitrai P. A Large Adult Postcricoid Lymphatic Malformation: A Case Report and Literature Review. Ear Nose Throat J 2024:1455613241229979. [PMID: 38321774 DOI: 10.1177/01455613241229979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Adult-onset lymphatic malformations arising at the postcricoid, a subsite of the hypopharynx, are sporadic. Only one case has been previously reported. In this study, we presented a 36-year-old female presented with globus sensation, dysphagia, and upper airway obstruction, requiring a tracheostomy. A computed tomography scan identified a 5 cm × 4.5 cm × 3 cm multilocular hypodense lesion in the postcricoid. Due to its considerable size, complete resection with function preservation was crucial, and a standard microscopic direct laryngoscopy approach may result in inadequate exposure, while an open transcervical approach may affect functional outcomes and increase surgical complications. We successfully performed an en bloc resection with a transoral endoscopic approach, using laryngeal suspension and a laparoscopic ultrasonic scalpel to preserve aerodigestive functions, ensure rapid recovery, and avoid neck scarring. The patient was decannulated within 2 weeks and remained disease-free after 1 year. The reported cases of adult-onset lymphatic malformations at the postcricoid and hypopharynx were reviewed and summarized for educational purposes.
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Affiliation(s)
- Hanpon Klibngern
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tapanut Ariyanon
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Sayanan Chowsilpa
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pichit Sittitrai
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Sop FYL, Benato A, Izoudine BK, Khouri K, Marangon A, Fraschetti F, Lonjon N, Ferraresi S. Spinal lymphangiomas: Case-based review of a chameleonic disease entity. J Craniovertebr Junction Spine 2024; 15:4-14. [PMID: 38644908 PMCID: PMC11029117 DOI: 10.4103/jcvjs.jcvjs_125_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/31/2023] [Indexed: 04/23/2024] Open
Abstract
Purpose Lymphangiomas are benign hamartomas in the spectrum of lymphatic malformations, exhibiting multifaceted clinical features. Spinal involvement is exceedingly rare, with only 35 cases reported to date. Both due to their rarity and chameleonic radiologic features, spinal lymphangiomas (SLs) are usually misdiagnosed; postoperatively, surgeons are thus confronted with an unexpected histopathological diagnosis with sparse pertinent literature and no treatment guidelines available. Methods Here, we report the case of a 67-year-old female who underwent surgery for a T6-T7 epidural SL with transforaminal extension, manifesting with spastic paraparesis. Then, we present the results of the first systematic review of the literature on this subject, delineating the clinical and imaging features and the therapeutic implications of this rare disease entity. Results Our patient was treated with T6-T7 hemilaminectomy and resection of the epidural mass, with complete recovery of her neurological picture. No recurrence was evident at 18 months. In the literature, 35 cases of SL were reported that can be classified as vertebral SL (n = 18), epidural SL (n = 10), intradural SL (n = 3), or intrathoracic lymphangiomas with secondary spinal involvement (n = 4). Specific treatment strategies (both surgical and nonsurgical) were adopted in relation to each of these categories. Conclusion Gathering knowledge about SL is fundamental to promote both correct preoperative identification and appropriate perioperative management of this rare disease entity. By reviewing the literature and discussing an exemplary case, we delineate a framework that can guide surgeons facing such an unfamiliar diagnosis.
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Affiliation(s)
- François Yves Legninda Sop
- Department of Neurosurgery, CHU Montpellier, Montpellier, France
- Department of Neurosurgery, Ospedale Santa Maria Della Misericordia, Rovigo, Italy
| | - Alberto Benato
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Kifah Khouri
- Department of Neurosurgery, CHU Montpellier, Montpellier, France
| | - Anna Marangon
- Department of Anesthesiology and Critical Care Medicine, Ospedale Santa Maria Della Misericordia, Rovigo, Italy
| | - Flavia Fraschetti
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicolas Lonjon
- Department of Neurosurgery, CHU Montpellier, Montpellier, France
| | - Stefano Ferraresi
- Department of Neurosurgery, Ospedale Santa Maria Della Misericordia, Rovigo, Italy
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9
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Bhole SS, Shah MY, Nazar Z. Cystic Lymphangioma Over the Lower Limb: A Case Report With a Literature Review. Cureus 2024; 16:e53259. [PMID: 38435955 PMCID: PMC10904878 DOI: 10.7759/cureus.53259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Cystic lymphangioma (CL) is a rare congenital deformity that almost exclusively affects children. Among the incidences, the majority occur in the head and neck area. Adults who develop these lesions likely develop them as a result of trauma. Here, we present the case of an adult female with a CL in the right calf region. Over time, it continued to grow to a noticeable size. Surgical resection was a good management strategy for the patient. We conducted a literature survey in light of scarce reports depicting CL in the limbic area.
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Affiliation(s)
- Sagarika S Bhole
- Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
| | - Mohd Yunus Shah
- Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
| | - Zansher Nazar
- Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND
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Tasis N, Mpalampou E, Sarafi A, Skafida E, Tsouknidas I, Fradelos E, Manatakis DK, Korkolis DP. Large cystic lymphangioma of the pancreas: unusual finding with differential diagnosis and therapeutic considerations. J Surg Case Rep 2023; 2023:rjad676. [PMID: 38130650 PMCID: PMC10733718 DOI: 10.1093/jscr/rjad676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/19/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023] Open
Abstract
Lymphangiomas are rare benign tumours of lymphatic vascular origin. They are more common in the paediatric population and manifest mainly in the neck and axillary region. Retroperitoneal lymphangiomas are <1% and pancreatic origin is even rarer. We present a case of a pancreatic cystic lymphangioma in a 60-year-old woman with chronic diffuse symptoms, diagnosed because of newly onset of diabetes mellitus. She was successfully managed with distal pancreatectomy and spleenectomy en-bloc with the cystic mass without any complications. Cystic lymphangioma of the pancreas is a rare entity presenting with a challenging preoperative diagnosis as imaging modalities may provide ambiguous information. The clinician should be aware of its complicated differential diagnosis and its persistent and subtle symptomatology.
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Affiliation(s)
- Nikolaos Tasis
- Department of Surgical Oncology, General Anticancer and Oncological Hospital of Athens “Saint Savvas”, Athens, Greece
- 2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
| | - Eleni Mpalampou
- Department of Surgical Oncology, General Anticancer and Oncological Hospital of Athens “Saint Savvas”, Athens, Greece
| | - Aikaterini Sarafi
- Department of Surgical Oncology, General Anticancer and Oncological Hospital of Athens “Saint Savvas”, Athens, Greece
| | - Evangelia Skafida
- Department of Pathology, General Anticancer and Oncological Hospital of Athens “Saint Savvas”, Athens, Greece
| | - Ioannis Tsouknidas
- Department of General Surgery, Lankenau Medical Center, Wynnewood, PA, United States
| | - Evangelos Fradelos
- 2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
| | | | - Dimitrios P Korkolis
- Department of Surgical Oncology, General Anticancer and Oncological Hospital of Athens “Saint Savvas”, Athens, Greece
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Iijima H, Noda T, Uchida K, Hakamata Y, Fujisaki A, Imai S, Otsuki Y, Yoneda T. A case of adrenal lymphangioma successfully treated with laparoscopic partial adrenalectomy. IJU Case Rep 2023; 6:341-344. [PMID: 37928276 PMCID: PMC10622198 DOI: 10.1002/iju5.12618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/26/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Adrenal lymphangioma is a rare benign tumor of lymphatic origin, usually incidentally detected from various imaging studies taken for an unrelated purpose. We present a case of a right adrenal lymphangioma treated successfully with surgical intervention. Case presentation A 36-year-old previously healthy woman was referred to our urology department for a right adrenal mass, discovered during a routine health checkup. The tumor had no endocrinological activity, and the patient opted for surgical resection following a concern for malignancy. A laparoscopic right partial adrenalectomy was performed, and on histological examination, the tumor was diagnosed as right adrenal lymphangioma. Conclusion Adrenal lymphangiomas lack disease specific radiological characteristics that allow for a definitive diagnosis from imaging alone. To rule out tumors of potentially malignant nature, surgical intervention should be considered.
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Affiliation(s)
- Heisuke Iijima
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Taisho Noda
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Kosuke Uchida
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Yasuhiro Hakamata
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Akira Fujisaki
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Shin Imai
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Yoshiro Otsuki
- Department of Pathology Seirei Hamamatsu General Hospital Shizuoka Japan
| | - Tatsuaki Yoneda
- Department of Urology Seirei Hamamatsu General Hospital Shizuoka Japan
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Bezerra HKF, Leonel ACLDS, Martins HDD, Carvalho EJDA, de Castro JFL, Bonan PRF, Perez DEDC. Oral Lymphatic Malformations: A 21-Year Retrospective Study in a Single Institution. Int J Surg Pathol 2023:10668969231201414. [PMID: 37853707 DOI: 10.1177/10668969231201414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Introduction. Oral lymphatic malformations are uncommon lesions. This study assessed the clinicopathological and sociodemographic features of oral lymphatic malformations in a Brazilian oral pathology service. Methods. Between 2000 and 2021, all oral lymphatic malformations diagnosed in a single oral pathology service were selected for the study. Clinical data, such as age, sex, site of the lesion, clinical presentation, diagnosis clinical, and the type of biopsy were recorded from the patient's clinical charts. Results. From 7554 oral lesions, 17 (0.22%) were oral lymphatic malformations. This lesion similarly affected both sexes, and the mean age of the patients was 16.5 years. The tongue was the most common site (n = 13; 76%). The mean size of the lesions was 17 mm. Oral lymphatic malformations were asymptomatic for 29% of the patients. Clinically, most lesions appeared as a reddish, sessile nodule, with a pebbly surface. In addition, the clinical and histopathological diagnoses agreed for most lesions (n = 11; 64%). The type of biopsy performed was excisional in 41% of lesions. Conclusions. In summary, oral lymphatic malformations present a low prevalence among the oral lesions diagnosed in an oral pathology service. Moreover, they affect equally both sexes, especially young patients, and usually appear as an asymptomatic or symptomatic nodular swelling on the tongue.
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Affiliation(s)
| | | | | | - Elaine Judite de Amorim Carvalho
- Clinical and Preventive Dentistry, Oral Pathology Section, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Jurema Freire Lisboa de Castro
- Clinical and Preventive Dentistry, Oral Pathology Section, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | | | - Danyel Elias da Cruz Perez
- Clinical and Preventive Dentistry, Oral Pathology Section, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
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Lu W, Cao Y, Zeng F, Chen C, Yang Z, Qi Z, Yang X. Surgical Treatment for Benign Lymphangioendothelioma After Two Incomplete Excisions: A Case Report and Literature Review. Clin Cosmet Investig Dermatol 2023; 16:2697-2719. [PMID: 37790904 PMCID: PMC10544170 DOI: 10.2147/ccid.s420019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/10/2023] [Indexed: 10/05/2023]
Abstract
Benign lymphangioendothelioma (BL) is a rare, poorly identified, slow-growing benign vascular lesion characterized by asymptomatic, solitary, well-demarcated macules, or by mildly infiltrated plaque. We report a case of an atypical BL that arose as a tender, protuberant, flesh-colored mass with cyanotic vesicles, and then progressed to a persistent exudative wound after two incomplete excisions. The patient was also diagnosed with thoracic duct narrowing. Although the stenosis was removed by surgery, the right lower extremity ulceration and exudation did not improve. Thus, we performed a thorough excision and split-thickness skin graft transplant following vacuum sealing drainage, and eventually the patient had a favorable functional and cosmetic outcome. A biopsy revealed irregular, dilated vascular spaces lined with a single layer of flat endothelial cells extending from the superficial dermis to the subcutis that did not reach the striated muscles. Additionally, by reviewing the literature on BL, in this paper we summarize the diverse pathogenic, morphological, and immunohistochemical presentations for this rare disease, as well as the histopathological differential diagnosis of lymphangiomatosis, Kaposi's sarcoma, and angiosarcoma.
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Affiliation(s)
- Wei Lu
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Yan Cao
- The Department of Pathology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Fanhua Zeng
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
- The Department of Burn and Plastic Surgery, Hengyang No.1 People’s Hospital, Hunan, People’s Republic of China
| | - Chun Chen
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
- E.N.T. Department, Shenzhen Longgang District Third People’s Hospital, Guangdong, People’s Republic of China
| | - Zhenyu Yang
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Zuoliang Qi
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Xiaonan Yang
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
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Zhou J, Guo L, Song D, Li J, Liu Z, Sun J, Niu Y. Cytological and Biochemical Analyses of Lymphatic Fluid from Patients with Lymphatic Malformations. Lymphat Res Biol 2023; 21:339-342. [PMID: 36780016 DOI: 10.1089/lrb.2021.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Background: Intracystic hemorrhage from lymphangiomas is a common phenomenon in lymphatic malformations (LMs); however, little is known about the associated compositional changes in the lymphatic fluid. Materials and Methods: We prospectively collected lymphatic fluid from children with LMs. Lymphatic fluid was divided depending on the bleeding status into the bleeding and nonbleeding groups. The fluid was subjected to cytological and biochemical analyses to determine protein and cytokine levels. The Mann-Whitney U test was used to compare the two groups. Results: There were significant differences in the levels of interleukin (IL)-6, IL-10, and glucose, and the percentage of white blood cells between the bleeding and nonbleeding groups. There was no significant difference in chlorine and protein content; white blood cell count; and IL-2, IL-4, tumor necrosis factor α, and interferon γ levels between the two groups. Conclusion: Lymphatic fluid is less stable in bleeding LMs than in non-bleeding LMs and is prone to inflammatory reactions. The inflammatory reaction in lymphatic fluid does not stimulate the cytokine storm in blood. The inflammatory reaction due to LMs does not affect the contents of protein and chlorine in lymphatic cyst fluid.
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Affiliation(s)
- Jie Zhou
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
| | - Lei Guo
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
| | - Dan Song
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
| | - Jing Li
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
| | - Zhuang Liu
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
| | - Jiali Sun
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
| | - Yanli Niu
- Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China
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15
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Balfour A, Raffi J, Lee BA, Kraus CN. Red vulvar plaque with unilateral edema. JAAD Case Rep 2023; 38:117-119. [PMID: 37521193 PMCID: PMC10372043 DOI: 10.1016/j.jdcr.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Affiliation(s)
- Alex Balfour
- School of Medicine, University of California, Irvine, California
| | - Jodie Raffi
- Department of Dermatology, University of California, Irvine, Irvine, California
| | - Bonnie A. Lee
- Department of Dermatology, University of California, Irvine, Irvine, California
| | - Christina N. Kraus
- Department of Dermatology, University of California, Irvine, Irvine, California
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16
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Pongsatha S, Jatavan P, Hantrakun P, Tongsong T. Prenatal Detection of Rapid Progressive Changes in Massive Lymphangioma from Flank to the Lower Extremity. Diagnostics (Basel) 2023; 13:2130. [PMID: 37443524 DOI: 10.3390/diagnostics13132130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 07/15/2023] Open
Abstract
Lymphangioma is a congenital anomaly in which abnormal lymphatic drainages localize to form a benign mass, but it has the tendency to grow in size and the potential to infiltrate surrounding structures, causing devastating effects and leading to severe morbidity. The most common site of lymphangioma is the neck region (cystic hygroma colli), whereas lymphangioma in the lower limbs is very rare, accounting for only 2% of cases. Accordingly, the prenatal diagnosis of lymphangioma of the lower limbs has been scarcely reported. This study describes two cases of lymphangioma of the lower limbs, focusing on unique sonographic features and the natural course of rapidly progressive changes, which is different from nuchal lymphangioma. Based on previous isolated case reports together with our two cases, lymphangioma of the lower limbs usually develops in the second trimester, tends to have rapidly progressive changes, and is unlikely to be associated with aneuploidy and structural anomalies. Diagnoses can be made by using sonographic findings pertaining to the subcutaneous complex and multi-septate anechoic cystic lesions in the lower limbs, the latter of which can infiltrate visceral structures. Prenatal detection can be helpful in laying the groundwork for providing counseling to the parents and the planning of management strategies, i.e., opting to terminate the pregnancy, revising delivery plans, and looking towards the postnatal management of the infant.
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Affiliation(s)
- Saipin Pongsatha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Phudit Jatavan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Panisa Hantrakun
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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17
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Duong A, Balfour A, Kraus CN. Acquired vulvar lymphangioma: risk factors, disease associations, and management considerations: a systematic review. Int J Womens Dermatol 2023; 9:e087. [PMID: 37234958 PMCID: PMC10208695 DOI: 10.1097/jw9.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/08/2023] [Indexed: 05/28/2023] Open
Abstract
Acquired vulvar lymphangioma (AVL) is not well-characterized. Diagnosis is delayed and the condition is often refractory to therapy. Objective The objective of this study was to provide a systematic review of AVL including risk factors, disease associations, and management options. Methods A primary literature search was conducted using 3 databases: PubMed, CINAHL, and OVID, from all years to 2022. Results In total, 78 publications with 133 patients (48 ± 17 years) were included. Most studies were case reports/series. The most common disease association was prior malignancy (70 patients, 53% of cases) and inflammatory bowel disease (6 patients, 5% of cases). The most common malignancy was cervical cancer (57 patients, 43% of cases). Most patients had prior radiation or surgery, with 36% (n = 48) treated with radiation, 30% (n = 40) with lymph node dissection, and 27% (n = 36) with surgical resection. Common presenting symptoms included discharge/oozing, pain, and pruritus. Most patients underwent surgical treatment for AVL with 39% treated with excision, 12% with laser therapy (the majority used CO2), and 11% with medical therapies. Most patients had failed prior therapies and there was a diagnostic delay. Limitations Retrospective nature. Most studies were limited to case reports and case series, with interstudy variability and result heterogeneity. Conclusion AVL is an underrecognized entity and should be considered in patients with a history of malignancy or radiation to the urogenital area. Treatment should include multidisciplinary care and address underlying lymphatic changes, manage any existing inflammatory conditions, and utilize skin-directed therapies and barrier agents while addressing symptoms of pruritus and pain. Prospective studies are needed to further characterize AVL and develop treatment guidelines.
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Affiliation(s)
- Amber Duong
- School of Medicine, University of California, Irvine, California
| | - Alex Balfour
- School of Medicine, University of California, Irvine, California
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18
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Ferreira-Santos RI, Santos KA, Scherma AP, León JE, Kaminagakura E. Unveiling an oral hemangio lymphangioma. Autops Case Rep 2023; 13:e2023435. [PMID: 37415646 PMCID: PMC10321783 DOI: 10.4322/acr.2023.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/29/2023] [Indexed: 07/08/2023]
Abstract
Hemangiolymphangioma is a very rare vascular malformation that develops as a combination of dilated venous and lymphatic vessels. We describe an unusual case of hemangiolymphangioma of the tongue affecting an adult man who complained of an uncomfortable, slowly progressing exophytic irregular dark red-violaceous nodular mass on his tongue that impaired speech and swallowing for two weeks. The clinical differential diagnoses were Kaposi's sarcoma and a COVID-19-related lesion. A complete blood count and serology for HIV-1 and 2 and RT-PCR for COVID-19 were requested and results were negative. An incisional biopsy was performed. Microscopically, the lesion exhibited several dilated vessels lined by normal-appearing endothelial cells, some filled with prominent intravascular erythrocytes and others containing proteinaceous eosinophilic material resembling lymphatic vessels, in close association with hyperkeratosis, papillomatosis, and acanthosis. From immunohistochemical analysis, most vessels were found to be CD34 positive, some highlighted by α-SMA, whereas D2-40 was focal. Positive staining for some lymphatic and blood vessel markers, i.e., D2-40 and CD34, respectively, indicates a mixed derivation of the lesion. HHV-8 was negative. Clinical features, the congested blood vessels with ectasia in intimate association with hyperplastic epithelium, and the immunohistochemical profile supported the final diagnosis of oral hemangiolymphangioma. The patient underwent minimally invasive surgical excision with no intercurrences. After 18 months of follow-up, there were no signs of relapse.
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Affiliation(s)
| | - Kamilla Alves Santos
- Universidade Estadual Paulista (UNESP), Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São José dos Campos, SP, Brasil
| | | | - Jorge Esquiche León
- Universidade de São Paulo (USP), Dental School, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto, SP, Brasil
| | - Estela Kaminagakura
- Universidade Estadual Paulista (UNESP), Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São José dos Campos, SP, Brasil
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19
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Park SH, Lee JH, Salas EN, Kim M, Han JI, Lee K, Yoon H. Case report: Generalized lymphatic anomaly of multiple abdominal organs in a young dog. Front Vet Sci 2023; 10:1154210. [PMID: 37215469 PMCID: PMC10196241 DOI: 10.3389/fvets.2023.1154210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/13/2023] [Indexed: 05/24/2023] Open
Abstract
A 9-month-old, female Pomeranian dog presented with vomiting and lethargy. Ultrasonography revealed multilobulated anechoic round shape structures at the ovarian and uterine locations. Through computed tomography scan, an extensive non-contrast multilobulated fluid-filled mass suspected of originating from the walls of the ovary, uterus, urinary bladder and rectum was observed. Ovariohysterectomy and urinary bladder biopsy were performed. Histopathological examination revealed numerous cystic lesions lined by plump cuboidal cells believed to be of epithelial origin. Immunohistochemical staining showed that the cyst-like lesions lining cells were strongly positive for lymphatic vessel endothelial hyaluronan receptor 1. Based on these results, lesions were identified as generalized lymphatic anomaly (GLA), in which lymphangiomas develop in multiple organs. After 6 months follow-up, the size of the cysts remaining in the region of the bladder did not undergo much change. GLA should be included in the differential diagnosis when multiple cystic lesions are interspersed in multiple organs.
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Affiliation(s)
- So-Hyeon Park
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Jung-Ha Lee
- V Animal Medical Center, Jeju-si, Jeju-do, Republic of Korea
| | | | - Myeongsu Kim
- Laboratory of Wildlife Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Jae-ik Han
- Laboratory of Wildlife Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
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20
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Safin DA, Tarusin DI, Matar AA. [ Lymphangioma of the scrotum]. Urologiia 2023:107-110. [PMID: 37401713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Lymphangioma (lymphatic malformation) is a congenital malformation of lymphatic vessels. According to the classification of the International Society for the Study of the Vascular Anomalies, there are macrocystic, microcystic and mixed types of lymphatic malformations. The typical location of the lymphangiomas is the area of large lymphatic collectors (head, neck, axillary areas), while the scrotum is not frequently affected. AIM To present a rare clinical case of lymphatic malformation of the scrotum with successful minimally invasive treatment (sclerotherapy). MATERIALS AND METHODS A clinical observation of a 12-year-old child with a diagnosis of "Lymphatic malformation of the scrotum" is presented. From the age of 4, there was a large lesion in the left half of the scrotum. In other clinic, a surgical removal with a diagnosis of "left-sided inguinal hernia", "spermatic cord hydrocele", "isolated left-sided hydrocele" was performed. However, there was a recurrence after the procedure. When contacting the Clinic of pediatrics and pediatric surgery, scrotal lymphangioma was suspected. The diagnosis was confirmed by magnetic resonance imaging. The patient underwent minimally invasive sclerotherapy using the drug "Haemoblock". After 6 months of follow-up, no relapse was seen. CONCLUSION Lymphangioma (lymphatic malformation) of the scrotum is a rare urological pathology that requires specific diagnosis, in-depth differential diagnosis and treatment by a multidisciplinary team of doctors, including a specialist in the treatment of vascular pathology.
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Affiliation(s)
- D A Safin
- Professional Medical Center, Clinic of Pediatrics and Pediatric Surgery, Moscow, Russia
| | - D I Tarusin
- Professional Medical Center, Clinic of Pediatrics and Pediatric Surgery, Moscow, Russia
| | - A A Matar
- Professional Medical Center, Clinic of Pediatrics and Pediatric Surgery, Moscow, Russia
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21
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Hakimi T. Giant cervical lymphangioma encompassing the neck great vessels (carotid artery and jugular vein): a case report. Ann Med Surg (Lond) 2023; 85:1923-1927. [PMID: 37229082 PMCID: PMC10205308 DOI: 10.1097/ms9.0000000000000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/16/2023] [Indexed: 05/27/2023] Open
Abstract
Lymphangiomas are benign congenital defects affecting the lymphatic system. These lesions commonly involve the head and neck, predominantly the posterior cervical triangle. Lymphangiomas cause obstructive symptoms in the upper airway and pose an esthetic concern to the patient. Clinically, these lesions are seen as cervical swelling, and a definite diagnosis is made by ultrasonography, computerized tomography scanning, and histopathologic analysis. Herein, the author present an unusual case of an 18-month-old child presenting with a huge cervical swelling on the right side with extension to the carotid triangle (encompassing neck great vessels) as well as unilateral neck and fascial disfigurement. The patient was treated surgically with the complete excision of the mass and followed up with an excellent esthetic result. Case presentation An 18-month-old child was brought to our teaching hospital's pediatric surgery department with a huge cervical mass on the right side since birth. Following the completion of work-up with the laboratory and imaging (computerized tomography scan) diagnostic modalities, the patient was prepared for definite treatment. Our team approached the mass through a right neck hockey stick incision, and with the preservation of the neurovascular bundle, the mass was completely excised. The patient was followed up for 12 months on two occasions, with excellent esthetic results and no relapse. Conclusion Lymphangiomas confined to the posterior cervical triangle are a common problem in children. Lesions extending to the anterior of the neck, especially those involving the neck neurovascular bundle, are uncommon entities. The decision to proceed with sclerotherapy or surgical excision should be justified, provided that, during the surgical procedure, the neurovascular bundle is preserved and none of the vital organs (neurovascular components) are compensated with the goal of a complete mass excision.
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Affiliation(s)
- Turyalai Hakimi
- Corresponding author. Address: Kabul Medical University, Kabul city, Kabul 1001, Afghanistan. Tel: +93 700 029 129. E-mail address: (T. Hakimi)
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22
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Chen YH, Huang SC, Hwang CF. A Rare Combination of Acquired Lymphangioma of the External Auditory Canal and Cholesteatoma in the Middle Ear Cavity. Ear Nose Throat J 2023:1455613231166577. [PMID: 37002810 DOI: 10.1177/01455613231166577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Lymphangioma (LM) is a rare but benign tumor derived from lymphatic malformation, which is extremely rare in the auditory canal or middle ear cavity. We presented a case of acquired lymphangioma of the external auditory canal combined with cholesteatoma in the middle ear cavity. To our best knowledge, this is the first case of combined lesions of lymphangioma and cholesteatoma in English literature.
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Affiliation(s)
- Yung-Hsuan Chen
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shun-Chen Huang
- Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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23
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Semba S, Kodama T, Nomura N, Sato Y, Urabe S, Hirata E. A case of cystic lymphangioma arising from the parauterine tissue. J Obstet Gynaecol Res 2023; 49:1048-1051. [PMID: 36582076 DOI: 10.1111/jog.15531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
A 57-year-old woman, gravida 3, para 3, with no complaints visited our hospital for right-sided adnexal tumor found incidentally in cancer screening. She had no medical history, surgical history, or gynecological disease. Imaging studies showed a 5-cm lobular cystic tumor on the right side of uterus. We suspected right hydrosalpinx and decided to perform diagnostic laparoscopy. During laparoscopy, the right adnexa was found to be atrophic, and the tumor was located in the broad ligament. The tumor was observed to be a multilocular cyst containing yellow fluid that developed from the right parauterine tissue. The tumor was resected from the surrounding tissue. Histological examination revealed that the multilocular cyst contained a vascular component surrounding the lymphatic endothelium and was decided to be a cystic lymphangioma. The patient was followed up and there was no evidence of recurrence at postoperative 7 months. We experienced a very rare case of lymphangioma arising from the parauterine tissue. The laparoscopic approach can assist with both diagnosis and treatment.
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Affiliation(s)
- Satoki Semba
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan
| | - Takashi Kodama
- Department of Reproductive Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Nana Nomura
- Department of Obstetrics and Gynecology, Higashihiroshima Medical Center, Hiroshima, Japan
| | - Yuki Sato
- Department of Obstetrics and Gynecology, Higashihiroshima Medical Center, Hiroshima, Japan
| | - Satoshi Urabe
- Department of Gynecology, Yasuda Hospital, Hiroshima, Japan
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24
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Alkhasov AB, Komina EI, Ratnikov SA, Romanova EA, Savelyeva MS, Kyarimov IA. [Isolated splenic lymphangioma]. Khirurgiia (Mosk) 2023:77-82. [PMID: 36800873 DOI: 10.17116/hirurgia202303177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Splenic lymphangioma is a rare malformation of splenic lymphatic channels characterized by cysts resulting from increased number of enlarged thin-walled lymphatic vessels. In our case, there were no clinical manifestations. Lymphangioma was congenital and diagnosed by ultrasound as an accidental finding. Surgery is the only method of radical treatment of splenic lymphangioma. We describe an extremely rare case of pediatric isolated splenic lymphangioma and laparoscopic resection of spleen as the most advantageous variant of surgical treatment.
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Affiliation(s)
- A B Alkhasov
- National Medical Research Center for Children's Health, Moscow, Russia
| | - E I Komina
- National Medical Research Center for Children's Health, Moscow, Russia
| | - S A Ratnikov
- National Medical Research Center for Children's Health, Moscow, Russia
| | - E A Romanova
- National Medical Research Center for Children's Health, Moscow, Russia
| | - M S Savelyeva
- National Medical Research Center for Children's Health, Moscow, Russia
| | - I A Kyarimov
- National Medical Research Center for Children's Health, Moscow, Russia
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25
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Alkwai H, Alkwai H, Al Namshan M. Sudden Appearance of a Palpable Chest Wall Mass Secondary to Macrocystic Lymphatic Malformation: A Case Report. Children (Basel) 2023; 10:children10020235. [PMID: 36832364 PMCID: PMC9954574 DOI: 10.3390/children10020235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/21/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Chest wall lymphatic malformations are rare and can pose a diagnostic dilemma, particularly if they present abruptly. This case report describes a 15-month-old male toddler presenting with a left lateral chest mass. Histopathology of the surgically excised mass confirmed the diagnosis of a macrocystic lymphatic malformation. Furthermore, there was no recurrence of the lesion in the two-year follow-up period.
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Affiliation(s)
- Hend Alkwai
- Department of Pediatrics, College of Medicine, University of Ha’il, Hail 55255, Saudi Arabia
- Correspondence:
| | - Hala Alkwai
- Department of Pulmonology, King Abdullah Specialized Children’s Hospital, Riyadh 14611, Saudi Arabia
| | - Mohammed Al Namshan
- Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, Riyadh 14611, Saudi Arabia
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26
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Waheed S, Seetlani NK, Ashfaq F, Tahir MJ, Abbasher Hussien Mohamed Ahmed K, Kumari V, Yousaf Z. Rare finding of duodenal lymphangioma in a patient with Helicobacter pylori associated gastritis: A case report. Medicine (Baltimore) 2022; 101:e31455. [PMID: 36451462 PMCID: PMC9704981 DOI: 10.1097/md.0000000000031455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Lymphangiomas are lymphatic malformations most commonly found in the head, neck and axilla. Their incidence in gastrointestinal tract, especially duodenum is very rare. They are mostly congenital and are usually seen in children. Owing to their asymptomatic nature, these tumors are often diagnosed incidentally. Surgical resection is the definite treatment. PATIENT CONCERNS We represent a case of a 30-year-old male with duodenal lymphangioma with presentation of intermittent dyspepsia for 1 year, partially relieved by a proton pump inhibitor. DIAGNOSES Upon physical examination, there was mild tenderness observed in the epigastrium. The rest of the physical examination was unremarkable. His complete blood count report was unremarkable. Upon a negative stool for Helicobacter pylori antigen test, the patient underwent an esophagogastroduodenoscopy which revealed H pylori gastritis and a duodenal lymphangioma. INTERVENTIONS Patient was put on triple therapy (clarithromycin, amoxicillin and omeprazole) for 14 days and his symptoms improved. The lymphangioma was not resected owing to small size. OUTCOMES Patient was followed till 1 year and his symptoms had improved. LESSONS The case describes a correlation between H pylori gastritis and a duodenal lymphangioma. There is likely to be an association between the two and therefore, further studies are required to find out any relationship that may exist between the 2 conditions.
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Affiliation(s)
| | - Naresh Kumar Seetlani
- Dr. Ruth K. M. Pfau, Civil Hospital, Karachi, Pakistan
- Dow Medical College, Karachi, Pakistan
| | - Fatima Ashfaq
- Nishtar Medical University and Hospital, Multan, Pakistan
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27
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Nagama T, Yamamoto I, Kuniyoshi K, Fukuda S, Kakudo N, Kusumoto K. Long-Term Follow-up With Multispecialty Management of a Giant Lymphangioma of an Infant Tongue Contributed to Reduced Complications of the Disease: A Case Report of a 21-Year Follow-up. Eplasty 2022; 22:e56. [PMID: 36545641 PMCID: PMC9748821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background. Lymphangiomas are benign tumors of abnormal lymphatic tissue. Approximately 6% of all lymphangiomas occur on the tongue. A lymphangioma of the tongue may present as a localized or a diffused growth, which may enlarge to cause macroglossia, impaired speech, and difficulty in mastication. This article reports a 21-year follow-up of a male infant who presented with a giant tongue lymphangioma. This long-term follow-up with multidisciplinary management including partial glossectomy, sclerotherapy, and orthodontic treatment to diminish complications of the disease in adulthood.
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Affiliation(s)
- Tae Nagama
- Kansai Medical University, Department of Plastic and Reconstructive Surgery, Osaka, Japan,Correspondence: Tae Nagama, MD;
| | | | - Kyoko Kuniyoshi
- Kansai Medical University, Department of Plastic and Reconstructive Surgery, Osaka, Japan
| | | | - Natsuko Kakudo
- Kansai Medical University, Department of Plastic and Reconstructive Surgery, Osaka, Japan
| | - Kenji Kusumoto
- Kansai Medical University, Department of Plastic and Reconstructive Surgery, Osaka, Japan
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Muacevic A, Adler JR. Recurrent Retroperitoneal Lymphatic Malformation in a Pediatric Patient: A Case Report. Cureus 2022; 14:e30846. [PMID: 36457604 PMCID: PMC9705061 DOI: 10.7759/cureus.30846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 01/25/2023] Open
Abstract
Retroperitoneal lymphatic malformations are rare, benign, cystic tumors of the lymphatic system, accounting for 1% of all lymphatic malformation manifestations. Lymphatic malformations are often asymptomatic, but may clinically present with abdominal pain and a palpable mass. Initial diagnostic workup is challenging due to the difficulty of differentiating from masses that may arise from the pancreas, liver, and kidney. This report describes a recurrent retroperitoneal lymphatic malformation in a 15-year-old male. The patient presented with abdominal pain and radiological imaging demonstrated abdominal fluid collection. Following conservative management using aspiration, the patient presented three months later with recurrent abdominal pain. Radiological imaging identified a large thin-walled cystic lesion in the right hemiabdomen containing minimal thin internal septations. Histological analysis confirmed the lymphatic malformation following computed tomography-guided biopsy. The patient underwent aspiration and was referred for outpatient sclerotherapy to prevent future abdominal fluid collection. This case highlights conservative management of recurrent retroperitoneal lymphatic malformation, both on the initial and subsequent presentation.
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29
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Deng D, Niu M, Yang J, Deng L. Simple Lymphangioma of the Scrotum: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:2017-2020. [PMID: 36172247 PMCID: PMC9512018 DOI: 10.2147/ccid.s375428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022]
Abstract
As scrotal simple lymphangioma is a rare benign proliferation of lymphatic vessels in the scrotum, a few reports were documented. A 68-year-old man gradually developed vesicles on the scrotum for ten years and easily ruptured due to friction. Physical examination showed diffuse millet-sized vesicles on the scrotum with milky white fluids and chyle-like exudates. Histopathological examination revealed proliferating and dilated lymphatic vessels with various sizes of lumens in the dermis. An immunohistochemical study showed positive staining for D2-40 and CD31. Therefore, the patient was diagnosed with scrotal lymphangioma and received carbon dioxide laser therapy. After the treatment, the vesicles markedly decreased, and no apparent exudates were observed. During one year of the follow-up, no relapse, scars, or other complications occurred.
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Affiliation(s)
- Dongmei Deng
- Department of Cosmetic Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Mu Niu
- Department of Cosmetic Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Jie Yang
- Department of Cosmetic Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Lijun Deng
- Department of Dermatovenereology, Wuzhong People's Hospital, Suzhou, People's Republic of China
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30
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Muromoto J, Sugibayashi R, Ozawa K, Wada S, Fujino A, Miyazaki O, Ito Y, Sago H. A fetus with large mediastinal cystic lymphatic malformation managed with prenatal serial thoracocentesis and postnatal sclerotherapy. J Obstet Gynaecol Res 2022; 48:3308-3313. [PMID: 36164802 DOI: 10.1111/jog.15436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/08/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
We report a very rare case of large fetal mediastinal cystic lymphatic malformation (cLM), formerly called lymphangioma, that was managed with prenatal serial thoracocentesis and postnatal sclerotherapy. A fetal pericardial effusion-like lesion gradually increased the size until it occupied more than half of the thoracic cavity. Thoracocentesis was performed three times, namely at 31 and 35 weeks of gestation, and also just before the delivery for decompression. The characteristic shape changes of the lesion were observed after thoracocentesis. A boy delivered by planned cesarian section at term required respiratory support after birth. Postnatal magnetic resonance imaging (MRI), which showed a large cystic lesion with septa and hemorrhage without solid components, led to the diagnosis of cLM. The fluid from the cyst continued to be drained. Neonatal sclerotherapy using OK-432 was effective and the infant recovered well. Fetal thoracocentesis may be useful for the diagnosis and management of a large mediastinal cLM.
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Affiliation(s)
- Jin Muromoto
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Rika Sugibayashi
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Katsusuke Ozawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Seiji Wada
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Yushi Ito
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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31
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Corda E, Russnak J, Kerr M. What is your diagnosis? Inguinal mass in a dog. Vet Clin Pathol 2022; 52 Suppl 2:113-115. [PMID: 36054281 DOI: 10.1111/vcp.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/05/2022] [Accepted: 05/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Erica Corda
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewana, Saskatoon, Saskatchewan, Canada.,Prairie Diagnostic Services Inc., Saskatoon, Saskatchewan, Canada
| | | | - Moira Kerr
- Prairie Diagnostic Services Inc., Saskatoon, Saskatchewan, Canada
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32
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Loloi J, Babar M, Azhar U, Cheng J, North A. Clinical challenges of scrotal lymphangioma in an adult: a rare case of scrotal swelling. Can J Urol 2022; 29:11262-11265. [PMID: 35969731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Scrotal lymphangiomas represent an extremely rare cause of scrotal swelling. We report a case of scrotal lymphangioma in an 18-year-old male who presented with painful scrotal swelling. Scrotal ultrasound revealed a complex multicystic structure in the left hemiscrotum. The patient underwent successful surgical excision of the mass. Postoperatively, he developed a hydrocele which eventually spontaneously regressed. Histopathology confirmed the diagnosis. We outline the unusual presentation, characteristic imaging and histology findings, and surgical management of scrotal lymphangiomas. With this information, urologists may exercise a heightened level of awareness for this rare cause of scrotal swelling.
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Affiliation(s)
- Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, New York, USA
| | - Mustufa Babar
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Umair Azhar
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jinrong Cheng
- Department of Pathology, Montefiore Medical Center, Bronx, New York, USA
| | - Amanda North
- Department of Urology, Montefiore Medical Center, Bronx, New York, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
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33
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Sadasivan A, Ramesh R. Lymphangioma Circumscriptum - A Rare Cause of Gingival Enlargement: A Case Report and Review of Literature. Clin Cosmet Investig Dent 2022; 14:199-206. [PMID: 35845977 PMCID: PMC9285531 DOI: 10.2147/ccide.s367281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background Lymphangiomas or microcystic lymphatic malformations (MLM) are hamartomatous formations that occur due to the proliferation of lymphatic vessels. They commonly manifest in the head and neck region with only a few cases reported within the oral cavity. Lymphangioma circumscriptum in the gingiva is a rare condition which presents as asymptomatic pebbly gingival enlargement. They are characterized by lesions that are microscopic thin-walled cysts. Histopathologically, they show multiple dilated lymphatic channels which are lined by endothelial cells. The lumen is filled with lymphatic fluid, red blood cells, and other inflammatory cells. These are dispersed within connective tissue stroma. Multiple modalities of treatment have been reported, including surgical excision, laser therapy, and sclerotherapy. Case Presentation This paper reports a rare case of multiple lymphangiomas of the gingiva in a 21-year-old female patient. The clinical picture, surgical treatment, histologic features, and immunohistochemistry [IHC] findings are presented. The histologic findings of lymphangioma were confirmed with IHC being positive for lymphatic marker D2-40. The patient was followed up for a period of 2 years, with no recurrence noted. Conclusion Lymphangiomas or microcystic lymphatic malformations presenting as a gingival enlargement are a rare occurrence. Therefore, lymphangiomas may also be considered in the differential diagnosis of gingival enlargements.
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Affiliation(s)
- Arun Sadasivan
- Department of Periodontics, SMIDS, Kulashekaram, Tamil Nadu, India
| | - Roshni Ramesh
- Department of Periodontics, Government Dental College, Trivandrum, Kerala, India
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34
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Diaz-Primera R, Sánchez-Jimenez R, Marin-Concha J, Mena R, Garrido-Mendez J, Mariñez M, Mena-Rivas R, Lopez A, Diaz-Rodriguez A, Mogena-Sanchez O, Almanzar R, Soto-Ravelo R. Prenatal Diagnosis of Fetal Lymphangioma: A Case Series. J Ultrasound Med 2022; 41:1019-1026. [PMID: 34288011 DOI: 10.1002/jum.15783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Fetal lymphangioma is an uncommon congenital malformation that is mainly comprised of the subcutaneous tissue of the neck. This malformation can develop in other areas like the thoracic and axillary regions, though rarely. We report 6 consecutive cases of lymphatic malformation in a fetal center in Dominican Republic. In our case series fetal chest lymphangiomas were present in 2 fetuses. In addition, 2 cases of axillary lymphangiomas also involved the thoracic region. Adequate management by a multidiciplinary team is necessary to provide a better approach to delivery.
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Affiliation(s)
- Ramiro Diaz-Primera
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Raúl Sánchez-Jimenez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Julio Marin-Concha
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Rafael Mena
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Jose Garrido-Mendez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Manuel Mariñez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Ramon Mena-Rivas
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Ashley Lopez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Agustin Diaz-Rodriguez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Orlando Mogena-Sanchez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Rafael Almanzar
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Rodolfo Soto-Ravelo
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
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35
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Kordjalik P, Szmyd B, Karuga FF, Daszkiewicz G, Strzelecka I, Respondek-Liberska M. The Value of Fetal Heart Evaluation in Fetuses with Rare Congenital Lymphangiomas: A Cohort Study from a Single Tertiary Center across Two Decades (Years 1999-2020). J Clin Med 2022; 11:1035. [PMID: 35207307 DOI: 10.3390/jcm11041035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022] Open
Abstract
Lymphangiomas are uncommon, benign (from a histopathology viewpoint) malformations of the lymphatic system with thin-walled vessels; however, these tumors may be dangerous for fetal or neonatal life. They are observed in 1:6000 newborns at birth and in 1:750 spontaneous abortions. We aimed to investigate the role of fetal echocardiography in the prognosis of lymphangioma. Selected data of 19,836 pregnant women studied between 1999 and 2020 were retrospectively analyzed. In total, 32 cases of lymphangioma meeting the following criteria were further analyzed: (1) ultrasound availability from the 1st trimester of pregnancy and (2) nuchal translucency ≤ 2.5 mm. Echocardiographic findings, karyotype, size, and location of the possible lesion were juxtaposed with the clinical follow-up. The statistical analysis was performed using Statistica 13.1 software (StatSoft, Tulsa, OK, USA). Lymphangioma in the analyzed material coexisted with abnormalities in fetal echo in 78% (n = 25) of cases, especially: heart defect in 50% (n = 16) and with normal heart structure with functional changes in 28% (n = 9). Karyotype was available in 50% of the analyzed cases (n = 16). Normal cytogenetic results were observed in 62.5% (n = 10) of cases. In the remaining cases, the following were observed: Turner Syndrome: 25% (n = 4) and Down Syndrome 12.5% (n = 2). The rate of alive newborns was significantly higher among fetuses with isolated lymphangioma in comparison to those with lymphangioma associated with abnormal ECHO examination: 38.46% (n = 5) vs. 15.38% (n = 2; p = 0.037). Abnormal ECHO exam was a poor prognostic sign for fetuses with lymphangioma; therefore, we think it is important to refer these cases for detailed echocardiography in tertiary centers. Moreover, it should be highlighted that in all lymphangioma cases there was an indication to perform the karyotype assessment, as there was a high risk of aneuploidy.
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36
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Sheppard SE, Sanders VR, Srinivasan A, Finn LS, Adams D, Elton A, Amlie-Lefond C, Nelson Z, Dmyterko V, Jensen D, Zenner K, Perkins J, Bennett JT. Cerebrofacial vascular metameric syndrome is caused by somatic pathogenic variants in PIK3CA. Cold Spring Harb Mol Case Stud 2021; 7:mcs.a006147. [PMID: 34887309 PMCID: PMC8751408 DOI: 10.1101/mcs.a006147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/30/2021] [Indexed: 12/26/2022] Open
Abstract
Disorganized morphogenesis of arteries, veins, capillaries, and lymphatic vessels results in vascular malformations. Most individuals with isolated vascular malformations have postzygotic (mosaic), activating pathogenic variants in a handful of oncogenes within the PI3K–RAS–MAPK pathway (Padia et al., Laryngoscope Investig Otolaryngol 4: 170–173 [2019]). Activating pathogenic variants in the gene PIK3CA, which encodes for the catalytic subunit of phosphatidylinositol 3-kinase, are present in both lymphatic and venous malformations as well as arteriovenous malformations in other complex disorders such as CLOVES syndrome (congenital, lipomatous, overgrowth, vascular malformations, epidermal anevi, scoliosis) (Luks et al., Pediatr Dev Pathol 16: 51 [2013]; Luks et al., J Pediatr 166: 1048–1054.e1–5 [2015]; Al-Olabi et al., J Clin Invest 128: 1496–1508 [2018]). These vascular malformations are part of the PIK3CA-related overgrowth spectrum, a spectrum of entities that have regionalized disordered growth due to the presence of tissue-restricted postzygotic PIK3CA pathogenic variants (Keppler-Noreuil et al., Am J Med Genet A 167A: 287–295 [2015]). Cerebrofacial vascular metameric syndrome (CVMS; also described as cerebrofacial arteriovenous metameric syndrome, Bonnet–Dechaume–Blanc syndrome, and Wyburn–Mason syndrome) is the association of retinal, facial, and cerebral vascular malformations (Bhattacharya et al., Interv Neuroradiol 7: 5–17 [2001]; Krings et al., Neuroimaging Clin N Am 17: 245–258 [2007]). The segmental distribution, the presence of tissue overgrowth, and the absence of familial recurrence are all consistent with CVMS being caused by a postzygotic mutation, which has been hypothesized by previous authors (Brinjiki et al., Am J Neuroradiol 39: 2103–2107 [2018]). However, the genetic cause of CVMS has not yet been described. Here, we present three individuals with CVMS and mosaic activating pathogenic variants within the gene PIK3CA. We propose that CVMS be recognized as part of the PIK3CA-related overgrowth spectrum, providing justification for future trials using pharmacologic PIK3CA inhibitors (e.g., alpelisib) for these difficult-to-treat patients.
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Affiliation(s)
- Sarah E Sheppard
- Division of Human Genetics, Department of Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Comprehensive Vascular Anomaly Program, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Victoria R Sanders
- Division of Human Genetics, Department of Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Comprehensive Vascular Anomaly Program, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Abhay Srinivasan
- Comprehensive Vascular Anomaly Program, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Division of Interventional Radiology, Department of Radiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Laura S Finn
- Department of Pathology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Denise Adams
- Comprehensive Vascular Anomaly Program, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Andrew Elton
- University of Minnesota School of Medicine, Minneapolis, Minnesota 55455, USA
| | | | - Zoe Nelson
- Seattle Children's Hospital, Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington 98105, USA
| | - Victoria Dmyterko
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington 98101, USA
| | - Dana Jensen
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington 98101, USA
| | - Kaitlyn Zenner
- Seattle Children's Hospital, Division of Pediatric Otolaryngology, Department of Otolaryngology/Head and Neck Surgery, University of Washington, Seattle, Washington 98105, USA.,Vascular Anomalies Program, Seattle Children's Hospital, Seattle, Washington 98105, USA
| | - Jonathan Perkins
- Seattle Children's Hospital, Division of Pediatric Otolaryngology, Department of Otolaryngology/Head and Neck Surgery, University of Washington, Seattle, Washington 98105, USA.,Vascular Anomalies Program, Seattle Children's Hospital, Seattle, Washington 98105, USA
| | - James T Bennett
- Seattle Children's Hospital, Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington 98105, USA.,Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington 98101, USA.,Vascular Anomalies Program, Seattle Children's Hospital, Seattle, Washington 98105, USA
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37
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Chen X, Wang D, Wang G, Huang Y, Yu X, Lu J, Zhai X, Xu H, Li Z. Optimization of Initial Dose Regimen for Sirolimus in Pediatric Patients With Lymphangioma. Front Pharmacol 2021; 12:668952. [PMID: 34819851 PMCID: PMC8606893 DOI: 10.3389/fphar.2021.668952] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/26/2021] [Indexed: 12/14/2022] Open
Abstract
Sirolimus is an effective oral treatment for pediatric patients with lymphangioma. The present clinical study in 15 children (0.12–16.39 years of age) examines the effects of underlying factors on sirolimus concentrations through application of a population pharmacokinetic model. Using Monte Carlo simulation, an initial dose regimen for sirolimus in pediatric patients with lymphangioma is presented. It is found that the lower the body weight, the higher the clearance rate and sirolimus clearances are 0.31–0.17 L/h/kg in pediatric patients with lymphangioma whose weights are 5–60 kg, respectively. The doses of sirolimus, 0.07, 0.06, 0.05 mg/kg/day are recommended for weights of 5–10, 10–24.5 and 24.5–60 kg in children with lymphangioma. This study is the first to establish a population pharmacokinetic model for sirolimus and to recommend initial doses in pediatric patients with lymphangioma. Large scale, prospective studies are needed in the future.
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Affiliation(s)
- Xiao Chen
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Dongdong Wang
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Guangfei Wang
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Yidie Huang
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Xin Yu
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Jinmiao Lu
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaowen Zhai
- Department of Hematology and Oncology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Xu
- Department of Nephrology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Zhiping Li
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
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38
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Bono GM, Maneiro LE, Martínez JE. Minimally invasive approach for the treatment of Giant retroperitoneal cystic tumors: Presentation of two cases and literature review. Rev Fac Cien Med Univ Nac Cordoba 2021; 78:322-5. [PMID: 34617699 DOI: 10.31053/1853.0605.v78.n3.32759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/05/2021] [Indexed: 11/21/2022] Open
Abstract
The primary retroperitoneal tumors are malignant or no malignant neoplasias, which the mesenteric cyst has an uncommon presentation. They have a great histological variety that includes the simple lymphatic cysts or the lymphangiomas which are congenital or acquired tumors whose intra-abdominal localization is unusual. There are three clinical features: incidental, unspecific and acute; and their therapeutic management is determinate by their radiological profile and it involves the preoperative percutaneous drainage in case of huge cysts for decreasing the size of the tumor and getting the radical cystectomy without relapse. This review presents two cases of acute abdominal pain related to huge retroperitoneal cysts resolved by minimally invasive approach and bibliographic review.
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39
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Abstract
Benign tumours of vascular and lymphatic origin are known as lymphangiomas. In this report, we present a case of a 26-year-old lady admitted with symptoms of small bowel obstruction. Her computed tomography (CT) scan showed a well-defined mass in the small bowel mesentery associated with small bowel volvulus. Segmental resection of the bowel, including the mass, was performed. Microscopic examination and immunohistochemistry of the specimen were consistent with lymphangioma of the small bowel mesentery.
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Affiliation(s)
| | - Suad Nassif
- General Surgery, North Manchester General Hospital, Manchester, GBR
| | - Yazan Alkurdi
- General Surgery, North Manchester General Hospital, Manchester, GBR
| | - Moustafa Mansour
- General Surgery, North Manchester General Hospital, Manchester, GBR
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40
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Meirelles DP, do Couto AM, Silva LVO, Abreu LG, de Sousa SCOM, Custódio M, Tarquinio SBC, Batista AC, Mendonça EF, Libório-Kimura TN, Louredo BVR, Romañach MJ, de Andrade BAB, Nonaka CFW, Alves PM, de Sena LSB, Mesquita RA, de Aguiar MCF. Oral lymphatic malformations: A multicenter study of 208 cases and literature review. Head Neck 2021; 43:3562-3571. [PMID: 34517432 DOI: 10.1002/hed.26854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/24/2021] [Accepted: 08/24/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To evaluate the frequency and analyze demographic and clinical characteristics of individuals with a histopathological diagnosis of oral lymphatic malformations (OLMs). METHODS A multicenter study was performed, collecting biopsy record data from a consortium of Brazilian Oral and Maxillofacial Pathology Centers. A review was also conducted to compare this data with cases already available in the literature. RESULTS This study retrieved 208 cases of OLM in the multicenter study and 1035 cases in the literature review. In both, OLMs affected male and female individuals equally, with the most affected site being the tongue. Individuals ≥60 years of age were uncommonly affected. Symptomatic and larger lesions were more commonly reported in the literature review. CONCLUSIONS This study comprises the largest sample of OLMs to date. OLMs are rare conditions, without sex predilection. The elderly proved to be less frequently affected, and the tongue is the most commonly affected site.
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Affiliation(s)
- Daniela P Meirelles
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Maria do Couto
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leni V O Silva
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas G Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Suzana C O M de Sousa
- Division of Oral and Maxillofacial Pathology, Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Marcos Custódio
- Division of Oral and Maxillofacial Pathology, Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Sandra B C Tarquinio
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Aline C Batista
- Department of Stomatology (Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Elismauro F Mendonça
- Department of Stomatology (Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Tatiana N Libório-Kimura
- Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Amazonas, Manaus, Brazil
| | - Brendo V R Louredo
- Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Amazonas, Manaus, Brazil
| | - Mário J Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruno A B de Andrade
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cassiano F W Nonaka
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | - Pollianna M Alves
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | - Luana S B de Sena
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | - Ricardo A Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria C F de Aguiar
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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41
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Bono GM, Maneiro LE, Martínez JE. [Minimally invasive approach for the treatment of Giant retroperitoneal cystic tumors: Presentation of two cases and literature review]. Rev Fac Cien Med Univ Nac Cordoba 2021. [PMID: 34617699 PMCID: PMC8760920 DOI: 10.3105310.31053/1853.0605.v78.n3.32759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The primary retroperitoneal tumors are malignant or no malignant neoplasias, which the mesenteric cyst has an uncommon presentation. They have a great histological variety that includes the simple lymphatic cysts or the lymphangiomas which are congenital or acquired tumors whose intra-abdominal localization is unusual. There are three clinical features: incidental, unspecific and acute; and their therapeutic management is determinate by their radiological profile and it involves the preoperative percutaneous drainage in case of huge cysts for decreasing the size of the tumor and getting the radical cystectomy without relapse. This review presents two cases of acute abdominal pain related to huge retroperitoneal cysts resolved by minimally invasive approach and bibliographic review.
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Affiliation(s)
- Gonzalo Matías Bono
- Instituto Medico Rio Cuarto
Hipólito Yrigoyen 1020. Rio Cuarto, Córdoba, Argentina. 5800
Rio CuartoCórdobaArgentina
| | - Luis Eduardo Maneiro
- Instituto Medico Rio Cuarto
Hipólito Yrigoyen 1020. Rio Cuarto, Córdoba, Argentina. 5800
Rio CuartoCórdobaArgentina
| | - José Esteban Martínez
- Instituto Medico Rio Cuarto
Hipólito Yrigoyen 1020. Rio Cuarto, Córdoba, Argentina. 5800
Rio CuartoCórdobaArgentina
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42
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Scharf JL, Gembicki M, Dracopoulos C, Hellenbroich Y, Offermann A, Stichtenoth G, Tafazzoli‐Lari K, Tharun L, Weichert J. Lymphangioma of the fetal neck within the PIK3CA-related-overgrowth spectrum (PROS): A case report. Clin Case Rep 2021; 9:e04527. [PMID: 34306701 PMCID: PMC8294145 DOI: 10.1002/ccr3.4527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/30/2021] [Accepted: 06/12/2021] [Indexed: 11/21/2022] Open
Abstract
The delineation of the prenatal diagnostic key features of PIK3CA-related overgrowth spectrum disorders will assume a crucial part in future and a prenatal diagnosis of the causing mutations would provide physicians with a simplified interdisciplinary perinatal management.
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Affiliation(s)
- Jann Lennard Scharf
- Department of Gynecology and ObstetricsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Michael Gembicki
- Department of Prenatal Medicine and Gynecological UltrasoundUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Christoph Dracopoulos
- Department of Gynecology and ObstetricsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Yorck Hellenbroich
- Institute of Human GeneticsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Anne Offermann
- Institute of PathologyUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Guido Stichtenoth
- Department of PediatricsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Kianusch Tafazzoli‐Lari
- Department of Pediatric SurgeryUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Lars Tharun
- Institute of PathologyUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Jan Weichert
- Department of Prenatal Medicine and Gynecological UltrasoundUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
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43
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Chouchene F, Masmoudi F, Baaziz A, Maatouk F, Ghedira H. Oral manifestations and dental care management of a young patient with lymphangioma of the tongue: A case report. Clin Case Rep 2021; 9:e04537. [PMID: 34322267 PMCID: PMC8299271 DOI: 10.1002/ccr3.4537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
Children with lymphangioma of the tongue may require a close collaboration between physician and dentist to establish preventive, conservative approaches, and eradicate any sources of dental infections before undertaking immunosuppressive therapy.
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Affiliation(s)
- Farah Chouchene
- Pediatric and Preventive Dentistry DepartmentFaculty of Dental Medicine of MonastirMonastirTunisia
- Laboratory of Biological, Clinical and Dento‐Facial ApproachUniversity of MonastirMonastirTunisia
| | - Fatma Masmoudi
- Pediatric and Preventive Dentistry DepartmentFaculty of Dental Medicine of MonastirMonastirTunisia
- Laboratory of Biological, Clinical and Dento‐Facial ApproachUniversity of MonastirMonastirTunisia
| | - Ahlem Baaziz
- Pediatric and Preventive Dentistry DepartmentFaculty of Dental Medicine of MonastirMonastirTunisia
- Laboratory of Biological, Clinical and Dento‐Facial ApproachUniversity of MonastirMonastirTunisia
| | - Fethi Maatouk
- Pediatric and Preventive Dentistry DepartmentFaculty of Dental Medicine of MonastirMonastirTunisia
- Laboratory of Biological, Clinical and Dento‐Facial ApproachUniversity of MonastirMonastirTunisia
| | - Hichem Ghedira
- Pediatric and Preventive Dentistry DepartmentFaculty of Dental Medicine of MonastirMonastirTunisia
- Laboratory of Biological, Clinical and Dento‐Facial ApproachUniversity of MonastirMonastirTunisia
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44
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Creger PE, Harper C, Curry C, Kramer A. Resection of an Asymptomatic Lymphangioma in a 76-Year-Old Male. Cureus 2021; 13:e15577. [PMID: 34277199 PMCID: PMC8270067 DOI: 10.7759/cureus.15577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/10/2021] [Indexed: 11/05/2022] Open
Abstract
Lymphangiomas are benign congenital malformation comprised of the lymphatic system. They typically present in the head, neck, and axillary regions of children with <1% being described in the small bowel mesentery. We report a case of a 76-year-old man who presented with incidental large (9x6 cm) multiloculated cystic mass in the right upper quadrant (RUQ) on a CT scan performed for nephrolithiasis. He was asymptomatic at the presentation. We performed a diagnostic laparoscopy which was converted to an open procedure due to the mesenteric mass extending deeply toward the mesenteric root. The depth of invasion required small bowel resection with primary side-to-side anastomosis. Pathology confirmed a lymphangioma of the small bowel mesentery with histopathological analysis and cytology negative for malignant cells. Lymphangiomas are benign masses, however, their complete resection, including the resection of the involved organs is necessary. Incomplete resection or drainage is no longer used in management due to high rates of recurrence. Mesenteric lymphangiomas, while typically benign congenital malformations, can progress and impact surrounding structures via mass effect. Definitive treatment of lymphangiomas, even when asymptomatic, should be complete resection.
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Affiliation(s)
- Paul E Creger
- Department of General Surgery, Kansas City University, Kansas City, USA
| | - Charles Harper
- Department of General Surgery, St. Mary's Medical Center, Blue Springs, USA
| | - Chelsea Curry
- Surgical Pathology, Centerpoint Medical Center, Independence, USA
| | - Adam Kramer
- Department of General Surgery, St. Mary's Medical Center, Blue Springs, USA
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45
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Liedtke KR, Käding C, Döring P, Bekeschus S, Glitsch AS. A case of giant retroperitoneal lymphangioma and IgG4-positive fibrosis: Causality or coincidence? SAGE Open Med Case Rep 2021; 9:2050313X211016993. [PMID: 34094565 PMCID: PMC8141978 DOI: 10.1177/2050313x211016993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
Several chronic inflammatory diseases have been found to be a subtype of IgG4-related disease, all of which have a typical clinical and histological change, which is based in particular on an overexpression of IgG4 and subsequent fibrosis. At least a part of the retroperitoneal fibrosis, which was originally classified as idiopathic, seems to be assigned to IgG4-related disease. Lymphangiomas are benign, cystic tumors that rarely occur in adults. However, there is no firm association with IgG4-related disease described in the literature to date. This report is about a patient suffering from acute renal failure due to a giant retroperitoneal cyst. Surgical resection remains incomplete in the iliac vessel area due to severe fibrosis and histology revealed features of both lymphangioma and IgG4+ fibrosis. The case description is followed by a brief overview of IgG4-related disease and a consideration of whether lymphangiomas might be assigned to this topic.
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Affiliation(s)
- Kim Rouven Liedtke
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany.,Department of Trauma and Orthopedic Surgery, Experimental Trauma Surgery, University Medical Center Schleswig-Holstein
| | - Christoph Käding
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany.,Department of Urology, Greifswald University Medical Centre, Greifswald, Germany
| | - Paula Döring
- Institute of Pathology, Greifswald University Medical Centre, Greifswald, Germany
| | - Sander Bekeschus
- Centre for Innovation Competence (ZIK) plasmatis, Leibniz Institute for Plasma Science and Technology (INP Greifswald), Greifswald, Germany
| | - Anne Susann Glitsch
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany
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46
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Gendvilaitė N, Drachneris J, Poškus T. Lymphangioma of the Mesentery: Case Report and Review of the Literature. Acta Med Litu 2021; 28:176-180. [PMID: 34393642 PMCID: PMC8311849 DOI: 10.15388/amed.2021.28.1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Lymphangioma of the mesentery is a rare benign condition. Lymphangioma usually occurs in children during first few years of life most likely because of congenital abnormality of the lymphatic system. It may also be caused by trauma, lymphatic obstruction, surgery, inflammatory process, or radiotherapy. Lymphangioma of the mesentery represents less than 1% of all lymphangiomas and about 70% of abdominal lymphangiomas. Case presentation: We report the case of the 42-year-old woman who was diagnosed with the lymphangioma. Laparotomy was performed. A cystic lymph-filled tumor of about 12 cm in diameter was removed from the ileum mesentery. Conclusions: Lymphangioma of the mesentery is a rare condition. Despite its benign nature, it can cause serious complications if not treated. Ultrasound and CT are used for detection of lymphangioma. It is important to surgically remove the lymphangiomas even in the absence of symptoms.
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Affiliation(s)
| | - Julius Drachneris
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Klinikos, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tomas Poškus
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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47
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Yang SX, Zhou YH, Zhang J, Miao L, Zhong JW, Wang WX, Xu CL, Cai ZZ, Lu GR. Haemorrhagic ileal haemo lymphangioma: a case report and review of the literature. J Int Med Res 2021; 49:300060520986677. [PMID: 33528281 PMCID: PMC7871067 DOI: 10.1177/0300060520986677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We describe herein a 37-year-old woman with a 2-week history of melena who was eventually diagnosed with ileal haemolymphangioma, a rare benign tumour. Local mucosal congestion and swelling were found through single-balloon enteroscopy, which showed an irregular protuberance approximately 10 cm long, located 3.2 m from the Treitz ligament. We performed a laparoscopic-assisted partial resection of the small intestine combined with intestinal adhesiolysis. According to postoperative pathology, the final diagnosis was ileal haemolymphangioma with haemorrhage.
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Affiliation(s)
- Shou-Xing Yang
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu-Hui Zhou
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jing Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lei Miao
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jing-Wei Zhong
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wen-Xing Wang
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chang-Long Xu
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhen-Zhai Cai
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guang-Rong Lu
- Department of Gastroenterology, The Second Affiliated Hospital of 26453Wenzhou Medical University, Wenzhou, Zhejiang, China
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48
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Aslan F, Güvenç İ, Aslan A, Günaydın E. Cystic Hygroma with Multiple Benign Bone Lymphangiomas in an Adult Patient: A Rare Entity in the Differential Diagnosis of Multiple Osseous Lesions in Oncology Practice. Curr Med Imaging 2021; 17:439-442. [PMID: 33327921 DOI: 10.2174/1573405616666201216100301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 09/26/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
Abstract
Cystic lymphangioma presenting with multiple bone lesions in an adult patient is a rare occurrence, with a limited number of reported cases in the literature. In this case report, we describe a 32-year old female patient with chronic neck and pelvic pain, and multiple lytic bone lesions on radiological imaging, which were eventually discovered to originate from cystic hygroma and widespread bone lymphangiomas that were present for more than 10 years. It should be kept in mind that there may be multiple benign causes of differential diagnosis in patients presenting with findings suggestive of diffuse bone metastasis. Misdiagnosis may cause the patient to receive unnecessary treatments, especially radiotherapy. In this case, we reached the diagnosis of benign disease, diffuse bone lymphangiomatosis. For this purpose, we also examine the long and stable medical history of the patient with the findings of BT, ultrasound, and bone scintigraphy. We think that as long as there are no stable and serious results ofclinical and radiological findings of the patient, the patient should be approached with medical follow-up without treatment.
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Affiliation(s)
- Ferit Aslan
- Department of Medical Oncology, Yüksek İhtisas University Medicalpark Ankara Batıkent Hospital, Ankara, Turkey
| | - İnanç Güvenç
- Department of Radiology, Yuksek Ihtisas University Medicalpark Ankara Batikent Hospital, Ankara, Turkey
| | - Aydın Aslan
- Department of Radiology, Yuksek Ihtisas University Medicalpark Ankara Batikent Hospital, Ankara, Turkey
| | - Elif Günaydın
- Department of Radiology, Yuksek Ihtisas University Medicalpark Ankara Batikent Hospital, Ankara, Turkey
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49
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Espinosa J, Ferreras MC, García D, Vallejo R, Pérez V. Case Report: Multiple Cavernous Pericardial Lymphangioma (Pericardial Lymphangiomatosis) in a Captive Peregrine Falcon ( Falco peregrinus brookei). Front Vet Sci 2021; 8:662157. [PMID: 33937381 PMCID: PMC8079740 DOI: 10.3389/fvets.2021.662157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022] Open
Abstract
A 12-year-old female peregrine falcon (Falco peregrinus brookei) from a private raptor breeding facility that presented a good body condition, died suddenly without showing previous symptoms. At necropsy, in the coelomic cavity, multiple cystic structures demarcated by a thin transparent wall and filled with a serous content were observed. They were firmly adhered to the cranial part of the epicardium and adjacent tissues and occupied the entire thoracic area of the coelomic cavity. Microscopically, emerging simultaneously from several areas the epicardium, multiple irregular channels and cystic spaces, lined by a single endothelial cell layer and separated by fibrovascular septa containing smooth muscle tissue, were observed. Immunohistochemical examination revealed that the neoplastic endothelial cells positively immunolabelled for the pan-endothelial marker factor VIII-related antigen but immunostained negative for cytokeratins (PCK26) while strong positivity for sarcomeric α-smooth muscle actin (α-SMA) was detected in the cystic walls. Based on the morphological and immunohistochemical findings, lesions were determined as consistent with a multiple cavernous pericardial lymphangioma, or pericardial lymphangiomatosis, a rare vascular neoplasm. The animal also showed a diffuse chronic perihepatitis, a necrotic area in the liver and foci of cartilaginous metaplasia and calcification in the aorta and vena cava. Literature review, particularly on the epidemiology of lymphangioma, demonstrated the rarity of this tumor in the different animal species and in this location, particularly in birds, being the first report of this type of tumor in a peregrine falcon.
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Affiliation(s)
- José Espinosa
- Departamento de Sanidad Animal, Facultad de Veterinaria, Instituto de Ganadería de Montaña (CSIC-ULE), Universidad de León, León, Spain
| | - M Carmen Ferreras
- Departamento de Sanidad Animal, Facultad de Veterinaria, Instituto de Ganadería de Montaña (CSIC-ULE), Universidad de León, León, Spain
| | | | - Raquel Vallejo
- Departamento de Sanidad Animal, Facultad de Veterinaria, Instituto de Ganadería de Montaña (CSIC-ULE), Universidad de León, León, Spain
| | - Valentín Pérez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Instituto de Ganadería de Montaña (CSIC-ULE), Universidad de León, León, Spain
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50
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Giri R, Dasnayak G, Raman S, Senapati U. Primary lymphangioma of palatine tonsil. J Oral Maxillofac Pathol 2021; 25:S81-S83. [PMID: 34083978 PMCID: PMC8123246 DOI: 10.4103/jomfp.jomfp_203_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 10/03/2020] [Accepted: 01/29/2021] [Indexed: 11/25/2022] Open
Abstract
Lymphangiomas are benign congenital tumors of the lymphatic system. Tonsillar lymphangiomas are extremely rare. Histopathological confirmation is essential to make the correct diagnosis. We report a case of primary lymphangioma of the left tonsil in a 17-year-old male patient who presented with difficulty in swallowing and was clinically diagnosed as a tonsillar cyst.
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Affiliation(s)
- Ranjana Giri
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Goutami Dasnayak
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sarojini Raman
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Urmila Senapati
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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