Huguet Kevin L, Metzger Philip P, Menke David M
Department of Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA.
Am Surg. 2007 Apr;73(4):414-6.
Lymphangiomas of the colon are historically rare benign tumors. Only 331 cases have been reported in the world medical literature between 1931 and 2004. With widespread use of colonoscopy, however, they are being found more frequently. We report the case of a 74-year-old woman in whom a colonoscopy revealed a 3 x 4-cm submucosal lesion in the cecum that was eventually diagnosed as a lymphangioma. A CT of the abdomen showed a soft-tissue mass in the cecum and a low-density hepatic lesion. An endoscopic ultrasound of the colon showed a 3 x 4-cm hypoechoic lesion with internal septa arising from the submucosal layer of the cecum. This lesion resembled a vascular malformation; therefore a biopsy specimen was not taken. Pathologic findings of a specimen taken after a subsequent right hemicolectomy identified a submucosal lymphangioma. Published reports indicate that colonoscopy cures most lesions smaller than 2.5 cm in diameter. Resection should be reserved for larger lesions or those in patients exhibiting protein-losing enteropathy.
结肠淋巴管瘤在历史上是罕见的良性肿瘤。1931年至2004年间，世界医学文献中仅报道了331例。然而，随着结肠镜检查的广泛应用，它们被发现的频率越来越高。我们报告了一例74岁女性病例，结肠镜检查发现其盲肠有一个3×4厘米的黏膜下病变，最终被诊断为淋巴管瘤。腹部CT显示盲肠有一个软组织肿块和一个低密度肝内病变。结肠内镜超声显示一个3×4厘米的低回声病变，内部有间隔，起源于盲肠黏膜下层。这个病变类似于血管畸形；因此未取活检标本。后续右半结肠切除术后标本的病理结果显示为黏膜下淋巴管瘤。已发表的报告表明，结肠镜检查可治愈大多数直径小于2.5厘米的病变。对于较大的病变或表现为蛋白丢失性肠病的患者，应进行手术切除。
