Tovichien Prakarn, Kaeotawee Phatthareeda, Udomittipong Kanokporn, Pacharn Preeyacha, Ruangchira-Urai Ruchira
Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.
Radiology Department, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.
Respirol Case Rep. 2021 Nov 24;9(12):e0881. doi: 10.1002/rcr2.881. eCollection 2021 Dec.
We report a case of mediastinal lymphatic venous malformations (LVM) in a 11-year-old boy who presented with chest pain after jumping into a swimming pool, with review of the literature. A superior mediastinal mass was incidentally found from the chest x-ray. Chest computed tomography revealed a large heterogenous mass at the left-sided mediastinum containing fat, minimal enhancing solid portion, non-enhancing cystic portion and calcification. Because of the large size of the mass, the patient underwent tumour removal. Operative findings gave a definitive diagnosis of mediastinal LVM. The patient had an uneventful clinical course and was discharged without complication. This report highlights that it is possible to misdiagnose mediastinal LVM especially if its predominant portion is lymphatic tissue with only minimal contrast enhancement. Tissue biopsy must be avoided because it may lead to haemorrhagic complication.
我们报告一例11岁男孩纵隔淋巴管静脉畸形(LVM)病例,该男孩跳入游泳池后出现胸痛,并对相关文献进行了回顾。胸部X线偶然发现上纵隔肿块。胸部计算机断层扫描显示左侧纵隔有一个大的异质性肿块,包含脂肪、少量强化的实性部分、无强化的囊性部分和钙化。由于肿块较大,患者接受了肿瘤切除术。手术所见明确诊断为纵隔LVM。患者临床过程平稳,无并发症出院。本报告强调,纵隔LVM可能会被误诊,尤其是当其主要部分为淋巴组织且仅有少量对比增强时。必须避免组织活检,因为这可能导致出血并发症。