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[颈胸段胸导管囊肿:一种罕见病症]

[Cervical thoracic duct cyst: An uncommon entity].

作者信息

Carreira-Delgado Manuel, Fernández-Rodríguez Elvira, Martínez-Míguez Marta, Álvarez-Martín María Jesús, Nuño Vázquez-Garza José Manuel

机构信息

Servicio de Cirugía General, Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, Vigo, España.

Servicio de Cirugía General, Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, Vigo, España.

出版信息

Cir Cir. 2017 Dec;85 Suppl 1:40-43. doi: 10.1016/j.circir.2016.11.010. Epub 2016 Dec 29.

Abstract

BACKGROUND

Cervical thoracic duct cysts are a rare anomaly.

OBJECTIVE

To report a case of cervical thoracic duct cyst, and perform a literature review.

CLINICAL CASE

A 78-year-old female, with a one-year history of a left-sided asymptomatic supraclavicular cystic mass. Computerized tomography revealed a cystic mass 42mm in diameter. We performed a fine needle aspiration puncture, obtaining a thick, milky, whitish liquid. The patient underwent surgery; finding a left-sided supraclavicular cystic mass, with some lymph vessels heading towards the jugulo subclavian venous junction. We performed a ligation of these lymph vessels and resection of the mass. The histopathologic study confirmed the diagnosis of thoracic duct cyst.

CONCLUSION

Diagnosis of cervical thoracic duct cyst should be suspected with a cystic lesion in the left supraclavicular region, which when perforated exudes a very distinctive thick milky, whitish liquid with a high content of lymphocytes and triglycerides. Treatment should be complete removal with ligation of the lymphatic afferent vessels.

摘要

背景

颈段胸导管囊肿是一种罕见的异常情况。

目的

报告一例颈段胸导管囊肿病例,并进行文献复习。

临床病例

一名78岁女性,左侧无症状锁骨上囊性肿块病史1年。计算机断层扫描显示一个直径42毫米的囊性肿块。我们进行了细针穿刺抽吸,获得一种浓稠、呈乳状、带白色的液体。患者接受了手术;发现左侧锁骨上囊性肿块,有一些淋巴管通向颈内静脉与锁骨下静脉汇合处。我们对这些淋巴管进行了结扎并切除了肿块。组织病理学研究证实了胸导管囊肿的诊断。

结论

对于左侧锁骨上区域的囊性病变,应怀疑颈段胸导管囊肿,穿刺时流出一种非常独特的浓稠、呈乳状、带白色的液体,淋巴细胞和甘油三酯含量很高。治疗应彻底切除并结扎淋巴输入血管。

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