Patoulias Dimitrios, Patoulias Ioannis, Kaselas Christos, Kalogirou Maria, Kyriakos Chatzopoulos, Konstantinos Farmakis, Feidantsis Thomas, Eleni Papacrivou
Department of Internal Medicine, General Hospital of Veria, Veria, Greece.
1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital G. Gennimatas, Thessaloniki, Greece.
Case Rep Pediatr. 2017;2017:2083204. doi: 10.1155/2017/2083204. Epub 2017 Oct 23.
Lymphangioma is a benign congenital malformation. The extremely rare and atypical localization of a lymphangioma in the chest wall was the real motive for the present case study. A 5-year-old boy was admitted to the Emergency Department of the 1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, due to the presence of a mildly painful swelling in the left lateral chest wall, which was first noticed three months ago, after a blunt injury during sport. Physical examination revealed the presence of a palpable, spherical, painful, nut-sized subcutaneous lesion in the left lateral chest wall, respectively, with the anterior axillary line, at the height of the 6th to 7th intercostal space. Presence of ecchymosis on the overlying skin was also noticed. During palpation, we did not notice fluctuation, while transillumination was not feasible. Performance of ultrasonography, including Doppler color flow imaging, followed, depicting a subcutaneous cystic lesion, 2.1⁎3.2 cm in dimensions, without extension to the thoracic cavity. Scheduled surgical excision of the lesion was decided. Histopathological examination documented the diagnosis of cystic lymphangioma. Patient is still followed up on a 6-month basis. He remains asymptomatic, after 2 years, without indication of relapse.
淋巴管瘤是一种先天性良性畸形。本病例研究的真正动机是胸壁淋巴管瘤极为罕见且非典型的定位。一名5岁男孩因左侧胸壁出现轻度疼痛性肿胀而入住塞萨洛尼基亚里士多德大学第一小儿外科急诊科,该肿胀在三个月前运动时受到钝伤后首次被发现。体格检查发现左侧胸壁前腋前线第6至7肋间高度分别有一个可触及的、球形、疼痛、坚果大小的皮下病变。还注意到覆盖皮肤有瘀斑。触诊时未发现波动,透光检查也不可行。随后进行了超声检查,包括彩色多普勒血流成像,显示一个皮下囊性病变,大小为2.1×3.2厘米,未延伸至胸腔。决定对病变进行预定的手术切除。组织病理学检查确诊为囊性淋巴管瘤。患者仍每6个月随访一次。两年后他仍无症状,无复发迹象。