Cyna-Gorse F, Frija J, Yana C, Ollier P, Laval-Jeantet M
Service de Radiologie, Hôpital Saint-Louis, Paris.
J Radiol. 1989 Jun-Jul;70(6-7):381-7.
Seven cases of lymphangioma and 3 cases of diffuse lymphangiomatosis have been studied with computed tomography (CT). In the 7 cases of local involvement, the tumor was located in the mediastinum (3 cases), the mesentery (2 cases), the spleen (1 case), and the pelvis (1 case). The disease was diffuse in 3 cases, involving the mesentery, the pelvis, the posterior mediastinum, the retroperitoneal space and the bones in the first case; in the second case, lymphangiomatosis was located in the posterior mediastinum, the spine (T12 and L3) and the right iliac wing; the third case showed diffuse involvement of the posterior mediastinum and of the spleen. The CT study allows suspecting the disease when it demonstrates an encapsulated tumor with liquid or fatty density and thin walls enhancing with contrast. Other, less typical appearances may be observed, which should not lead to challenging this diagnosis. The CT exploration provides a complete assessment of the lesions, including the detection of tumors not seen on plain radiographs. In addition, CT is useful for the prognosis since it identifies the diffuse forms, which are naturally prone to aggravation, or recurrence when surgery has been indicated. Lymphangioma and lymphangiomatosis seem to be different forms of the same abnormality of the lymphatic system, either local or scattered.
对7例淋巴管瘤和3例弥漫性淋巴管瘤病进行了计算机断层扫描(CT)研究。在7例局部受累病例中,肿瘤位于纵隔(3例)、肠系膜(2例)、脾脏(1例)和骨盆(1例)。3例为弥漫性病变,第一例累及肠系膜、骨盆、后纵隔、腹膜后间隙和骨骼;第二例淋巴管瘤病位于后纵隔、脊柱(T12和L3)和右髂翼;第三例表现为后纵隔和脾脏的弥漫性受累。当CT显示为有液体或脂肪密度且壁薄、增强扫描有强化的包膜性肿瘤时,可怀疑该病。也可能观察到其他不太典型的表现,但这不应导致对该诊断提出质疑。CT检查可对病变进行全面评估,包括发现平片上未见的肿瘤。此外,CT对预后评估也有用,因为它能识别出弥漫性病变,这些病变自然易于加重,或在已进行手术时易于复发。淋巴管瘤和淋巴管瘤病似乎是淋巴系统同一异常的不同形式,可为局部或散在性。