Mazhar Aqsa, Shazlee Muhammad Kashif, Mallick Yousuf Abd, Muhammad Ammar Ali, Samad Lubna
Vascular Anomallies Center Clinic, Indus Hospital and Health Network, Karachi, Pakistan.
Department of Radiology, Indus Hospital and Health Network, Karachi, Pakistan.
J Pak Med Assoc. 2023 Feb;73(2):290-293. doi: 10.47391/JPMA.5623.
To evaluate the efficacy of bleomycin in the treatment of lymphatic malformations, and the concordance between photographic and radiological assessments of the outcome.
The retrospective study was conducted at the Vascular Anomalies Centre of Indus Hospital, Karachi, and comprised data of patients enrolled with diagnosis of macrocystic or mixed lymphatic malformations from January 2017 to November 2019. All patients had been treated with injection bleomycin 0.6-1mg/kg/session. Size and location of lesions, ultrasonographic findings, photographic documentation and post-procedure complications were reviewed. Photographic and radiographical assessment outcomes were categorised as excellent, good or poor, and compared for concordance. Data was analysed using Stata 14.
Of the 31 children, 22(68.8%) were boys. Mean age at presentation was 54.2±44 months (range: 2 months to 15.7 years). There were 32 lymphatic malformations; 29(90.6) macrocystic and 3(9.4%) mixed. Head and neck region was mostly involved 19(59.4%). Most lesions 23(71.9%) presented during the first year of life, and 29(90.6%) lesions were purely macrocystic. Excellent, good and poor response was seen in 16(50%), 15(46.9%) and 1(3.1%) lesions on photographic assessment, and 21(65.6%), 11(34.4%) and 0(0.0%) lesions on radiological assessment, respectively. Concordance in photographic and radiological outcomes was 22(69%). No complications were seen and no statistically significant difference was observed for photographic and radiographic assessment with respect to gender, malformation type, region involved, and number of sessions (p>0.05).
Intralesional bleomycin sclerotherapy was found to be effective in the treatment of lymphatic malformations. Clinical observation was reliable in assessing progress on routine follow-up, with additional radiology done when management decisions needed to be reviewed.
评估博来霉素治疗淋巴管畸形的疗效，以及治疗结果的照片评估与放射学评估之间的一致性。
这项回顾性研究在卡拉奇印度河医院血管畸形中心进行，纳入了2017年1月至2019年11月期间诊断为大囊型或混合型淋巴管畸形的患者数据。所有患者均接受了博来霉素注射治疗，每次剂量为0.6 - 1mg/kg。回顾了病变的大小和位置、超声检查结果、照片记录以及术后并发症。照片和放射学评估结果分为优、良或差，并比较其一致性。使用Stata 14软件进行数据分析。
31名儿童中，22名（68.8%）为男孩。就诊时的平均年龄为54.2±44个月（范围：2个月至15.7岁）。共有32处淋巴管畸形；29处（90.6%）为大囊型，3处（9.4%）为混合型。头颈部受累最为常见，共19处（59.4%）。大多数病变（23处，71.9%）在出生后第一年内出现，29处（90.6%）病变为单纯大囊型。照片评估中，16处（50%）病变反应为优，15处（46.9%）为良，1处（3.1%）为差；放射学评估中，分别有21处（65.6%）、11处（34.4%）和0处（0.0%）病变为优、良和差。照片和放射学评估结果的一致性为22处（69%）。未观察到并发症，照片和放射学评估在性别、畸形类型、受累区域和治疗次数方面均未观察到统计学显著差异（p>0.05）。
瘤内注射博来霉素硬化治疗被发现对淋巴管畸形有效。临床观察在常规随访中评估病情进展方面可靠，在需要重新评估治疗决策时可进行额外的放射学检查。
