Stárek I, Salzman R, Pokorná Z, Skanderová D
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I.P. Pavlova 6, 77900 Olomouc, Czech Republic.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I.P. Pavlova 6, 77900 Olomouc, Czech Republic.
Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Mar;137(2):123-125. doi: 10.1016/j.anorl.2019.01.002. Epub 2019 Sep 30.
Cysts originating from cervical lymphatic ducts are very rare affections. However, they play an important role in the differential diagnosis of supraclavicular masses. The aetiology remains unclear. Practically all cases arise from the thoracic duct; those affecting the right lymphatic duct are encountered very exceptionally.
In the presented case report of a right lymphatic duct cyst, we analyzed the possible reasons for the diametrically differing incidence of cysts arising from the thoracic duct and those related to the right lymphatic duct.
The cysts manifest themselves clinically as an otherwise asymptomatic supraclavicular swelling. The diagnosis is based on imaging. High T-lymphocytes and triglyceride levels in an aspirate are pathognomonic. There is no uniform opinion on the therapy. The majority of authors recommend surgical removal. Lymphatic vessels entering the cyst must be intraoperatively ligated to prevent lymph leakage.
起源于颈淋巴管的囊肿是非常罕见的病症。然而，它们在锁骨上肿块的鉴别诊断中起着重要作用。其病因仍不清楚。实际上，所有病例均起源于胸导管；累及右淋巴管的病例极为罕见。
在本例右淋巴管囊肿的病例报告中，我们分析了胸导管囊肿与右淋巴管囊肿发生率截然不同的可能原因。
这些囊肿临床上表现为锁骨上无痛性肿胀。诊断基于影像学检查。抽吸液中高T淋巴细胞和甘油三酯水平具有诊断意义。关于治疗尚无统一意见。大多数作者建议手术切除。术中必须结扎进入囊肿的淋巴管以防止淋巴漏。
