Tang Gongshun
West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Vasc Surg Cases Innov Tech. 2020 Feb 1;6(1):1-5. doi: 10.1016/j.jvscit.2019.10.003. eCollection 2020 Mar.
Prepubertal vaginal discharge is most commonly caused by vulvovaginitis and is rarely caused by lymphatic malformations, resulting in chylous vaginal discharge. The diagnosis of chylous vaginal discharge remains a challenge because of a knowledge gap. We describe a 12-year-old girl with intermittent vaginal discharge for 10 years. Although we found a high signal in the vagina on T2-weighted magnetic resonance imaging (MRI), the final diagnosis, vaginal lymphatic leakage, was established on lymphoscintigraphy. Lymphatic leakage in the vagina on lymphoscintigraphy was the key imaging feature of chylous vaginal discharge in this patient. Moreover, diffuse radioactivity was found in the abdomen and thorax on lymphoscintigraphy, which indicated the multiple cystic lymphatic malformations and intestinal lymphangiectasia combined with T2-weighted MRI. Thus, T2-weighted MRI could be used in combination with lymphoscintigraphy to simply identify chylous vaginal discharge.
青春期前阴道分泌物最常见的原因是外阴阴道炎，很少由淋巴管畸形引起，导致乳糜性阴道分泌物。由于知识差距，乳糜性阴道分泌物的诊断仍然是一项挑战。我们描述了一名12岁女孩，有10年间歇性阴道分泌物。尽管我们在T2加权磁共振成像（MRI）上发现阴道有高信号，但最终诊断为阴道淋巴漏是通过淋巴闪烁造影确定的。淋巴闪烁造影显示阴道淋巴漏是该患者乳糜性阴道分泌物的关键影像学特征。此外，淋巴闪烁造影在腹部和胸部发现弥漫性放射性，这表明存在多囊性淋巴管畸形和肠淋巴管扩张，并结合T2加权MRI。因此，T2加权MRI可与淋巴闪烁造影联合使用，以简单地识别乳糜性阴道分泌物。
