Department of General Surgery, General Hospital of PLA Beijing Military Command, Beijing 100700, China.
World J Gastroenterol. 2013 Mar 7;19(9):1494-7. doi: 10.3748/wjg.v19.i9.1494.
Intestinal hemolymphangioma is a rare vascular and lymphatic malformation and is manifested as anaemia and recurrent alimentary tract hemorrhage. Few cases of hemolymphangioma occurring in small intestine, spleen, esophagus and other organs have been reported. We herein report a case of a 37-year-old man with severe rectal bleeding. Digital examination revealed nodular mucosa. No rectal mass was palpated, but bleeding in the ampulla was detected. Colonoscopy revealed an extensive hypervascular submucosal lesion arising from the rectosigmoid junction colon to the distal edge of the anus. Endoscopic ultrasonography demonstrated an extensive anechoic mass with clear edge. Magnetic resonance imaging (MRI) showed a significant thickness of the rectal wall, extending to the distal edge of the anus, with a narrowing lumen. A sphincter-saving rectal surgery was performed. Due to a lack of knowledge of the clinical, endoscopic and radiological features, preoperative recognition of hemolymphangioma is not easy. Computed tomography and MRI are helpful in confirming the diagnosis, and defining the extent and invasion of the lesion. For the low malignant potential tumors, a sphincter-saving rectal surgery is recommended after a full evaluation of the tumor.
肠淋巴管瘤是一种罕见的血管和淋巴管畸形，表现为贫血和反复消化道出血。小肠、脾脏、食管等其他器官发生的淋巴管瘤病例较少见。本文报告 1 例 37 岁男性，因严重直肠出血就诊。肛门指诊发现黏膜呈结节状。未触及直肠肿块，但可探测到壶腹部出血。结肠镜检查显示直肠乙状结肠交界处至肛门远端有广泛的富血管黏膜下病变。内镜超声检查显示边界清晰的广泛无回声肿块。磁共振成像（MRI）显示直肠壁显著增厚，延伸至肛门远端，管腔狭窄。行保留肛门的直肠手术。由于对该病的临床、内镜和影像学特征认识不足，术前识别淋巴管瘤并不容易。CT 和 MRI 有助于明确诊断，并确定病变的范围和侵犯程度。对于低度恶性潜能的肿瘤，在充分评估肿瘤后建议行保留肛门的直肠手术。
