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乙状结肠淋巴管瘤病——下消化道出血的罕见病因:一例病例报告及文献复习

Lymphangiomatosis of the sigmoid colon - a rare cause of lower gastrointestinal bleeding: A case report and review of the literature.

作者信息

Lu Guifang, Li Hongxia, Li Yuanyuan

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.

出版信息

Oncol Lett. 2017 Jan;13(1):339-341. doi: 10.3892/ol.2016.5399. Epub 2016 Nov 21.

Abstract

The present study reports the case of a 79-year-old Chinese man who presented to The First Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) for the treatment of lower gastrointestinal bleeding. Multiple cystic masses in the sigmoid colon were observed with colonoscopy, and through endoscopic ultrasound (EUS), these cystic masses were confirmed to be echo-free and to exhibit septal walls in the submucosal layer; in consequence, lymphangiomatosis of the sigmoid colon was diagnosed. Considering the repeated bleeding, laparoscopy-assisted partial sigmoid colon resection was performed. The excised specimens were multiple vesicular and soft masses of ~1 cm in diameter, which were located in the submucosal layer and were surrounded by flat endothelial cells. Immunohistochemistry revealed that the specimens were positive for the specific lymphatic endothelial marker D2-40. The pathological diagnosis was consistent with the EUS findings. In the 2-year follow-up after the operation, no bleeding or other complications were noticed.

摘要

本研究报告了一名79岁中国男性的病例,该患者因下消化道出血前往西安交通大学第一附属医院(中国西安)就诊。结肠镜检查发现乙状结肠有多个囊性肿物,经内镜超声(EUS)检查,这些囊性肿物被确认为无回声,且在黏膜下层可见分隔;因此,诊断为乙状结肠淋巴管瘤病。考虑到反复出血,遂行腹腔镜辅助部分乙状结肠切除术。切除标本为多个直径约1 cm的囊状软块,位于黏膜下层,周围为扁平内皮细胞。免疫组化显示标本对特异性淋巴管内皮标志物D2-40呈阳性。病理诊断与EUS检查结果一致。术后2年随访未发现出血或其他并发症。

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