Yin Yefeng, Wang Rongdi, Wang Xishan
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Anorectal Surgery, Dalian Municipal Central Hospital, Dalian, China.
Front Oncol. 2022 Oct 20;12:933777. doi: 10.3389/fonc.2022.933777. eCollection 2022.
Lymphangiomatosis is an extremely rare disease with potential soft tissue, bone, and spleen involvement, which can be characterized by lymphangioma. Only a few cases of colon and mesenteric lymphangiomatosis have been reported. We report a case presenting with fatigue, periumbilical pain, and intermittent bloody stools. This patient underwent a series of examinations. Exploratory laparoscopy, in particular, yielded very valuable images and videos for this disease, which can provide evidence for the diagnosis of this disease.
The current patient had fatigue, periumbilical pain, and intermittent bloody stools. Colonoscopy indicated numerous variable-sized hyaline cysts in the colon. Submucosal puncture was performed during colonoscopy. The patient was readmitted to the hospital due to periumbilical pain. B-ultrasound and abdominal CT showed multiple hypoechoic nodules in the mesenteric area. Exploratory laparoscopy was performed, and histopathology revealed that D2-40 was positive. Based on auxiliary examination and laparoscopic biopsy, surgeons and pathologists reached the diagnosis of mesenteric lymphangiomatosis.
Clinicians need to comprehensively improve their knowledge of lymphangiomatosis, and the combination of clinical symptoms, histological characteristics, and colonoscopy biopsy findings should be considered to improve lymphangiomatosis diagnosis, thereby reducing misdiagnosis.
Colon and mesenteric lymphangiomatosis is an extremely uncommon benign condition of unknown etiology and pathogenesis in adult patients. We report a case of mesenteric lymphangiomatosis in a 37-year-old woman who presented with fatigue, periumbilical pain, and intermittent bloody stools, as well as lesions in the kidney, spleen, and bones. This case provides new insights into the diagnosis and treatment of this disease.
淋巴管瘤病是一种极其罕见的疾病，可能累及软组织、骨骼和脾脏，其特征为淋巴管瘤。仅有少数结肠和肠系膜淋巴管瘤病的病例报道。我们报告一例表现为乏力、脐周疼痛和间歇性便血的病例。该患者接受了一系列检查。特别是 exploratory laparoscopy（此处可能有误，推测为“ exploratory laparoscopy”，即“ exploratory laparoscopy”，中文为“探查性腹腔镜检查”）为该疾病提供了非常有价值的图像和视频，可为该疾病的诊断提供依据。
该患者有乏力、脐周疼痛和间歇性便血。结肠镜检查显示结肠内有许多大小不一的透明囊肿。结肠镜检查期间进行了黏膜下穿刺。患者因脐周疼痛再次入院。B超和腹部CT显示肠系膜区域有多个低回声结节。进行了探查性腹腔镜检查，组织病理学显示D2-40阳性。基于辅助检查和腹腔镜活检，外科医生和病理学家得出肠系膜淋巴管瘤病的诊断。
临床医生需要全面提高对淋巴管瘤病的认识，应考虑结合临床症状、组织学特征和结肠镜活检结果以改善淋巴管瘤病的诊断，从而减少误诊。
结肠和肠系膜淋巴管瘤病在成年患者中是一种病因和发病机制不明的极其罕见的良性疾病。我们报告一例37岁女性的肠系膜淋巴管瘤病病例，该患者表现为乏力、脐周疼痛和间歇性便血，同时肾脏、脾脏和骨骼也有病变。该病例为该疾病的诊断和治疗提供了新的见解。
