Sadrizadeh Ali, Etemad Rezaie Hamid, Soltani Ehsan
Department of Cardiothoracic Surgery, Qaem University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Spine J. 2009 Aug;9(8):e1-5. doi: 10.1016/j.spinee.2009.01.007. Epub 2009 Feb 24.
The lumbar lymphangioma occurs rarely. Several studies have presented cases with the involvement of multiple vertebrae in presence or absence of the other bones and/or adjacent soft tissue. We elucidate a rare case of lumbar lymphangioma which presents as chylothorax.
To report a rare case of lumbar lymphangioma presenting as chylothorax.
A case report.
A 32-year-old man was admitted with lumbar and chest pain. Lumbar plain radiography, computed tomography (CT) scan and magnetic resonance imaging revealed L2 vertebra's sclerosis and destruction with canal compression leading up to vertebral lymph/hemangioma impression. Chest radiograph revealed a left-sided pleural effusion that further examination confirmed the chylothorax. Because of medical treatment failure in managing the chylothorax, surgical exploration was performed on. The involved vertebra was resected and stabilized with a mass ligation of its adjacent soft tissues. Histopathologic study of the resected material confirmed the diagnosis of lymphangioma. Serial plain radiography and CT scan were performed at postoperative follow-up.
Following up assessments showed that the chylothorax resolved. Also, the pain significantly relieved.
To the authors' knowledge, this is a unique reported case of lymphangioma affecting lumbar vertebral body presenting as chylothorax. Further observation is recommended because of the possibility of local recurrence.
腰椎淋巴管瘤罕见。多项研究报道了伴有或不伴有其他骨骼和/或相邻软组织受累的多节段椎体受累病例。我们阐述了一例表现为乳糜胸的罕见腰椎淋巴管瘤病例。
报告一例表现为乳糜胸的罕见腰椎淋巴管瘤病例。
病例报告。
一名32岁男性因腰背痛入院。腰椎X线平片、计算机断层扫描（CT）和磁共振成像显示L2椎体硬化、破坏并伴有椎管受压，提示椎体淋巴管/血管瘤。胸部X线片显示左侧胸腔积液，进一步检查确诊为乳糜胸。由于药物治疗乳糜胸失败，遂进行手术探查。切除受累椎体并对其相邻软组织进行大块结扎固定。对切除组织进行组织病理学研究确诊为淋巴管瘤。术后随访进行了系列X线平片和CT扫描。
随访评估显示乳糜胸消失，疼痛也明显缓解。
据作者所知，这是一例独特的报道病例，即影响腰椎椎体的淋巴管瘤表现为乳糜胸。鉴于有局部复发的可能，建议进一步观察。
