Pongsatha Saipin, Jatavan Phudit, Hantrakun Panisa, Tongsong Theera
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Diagnostics (Basel). 2023 Jun 21;13(13):2130. doi: 10.3390/diagnostics13132130.
Lymphangioma is a congenital anomaly in which abnormal lymphatic drainages localize to form a benign mass, but it has the tendency to grow in size and the potential to infiltrate surrounding structures, causing devastating effects and leading to severe morbidity. The most common site of lymphangioma is the neck region (cystic hygroma colli), whereas lymphangioma in the lower limbs is very rare, accounting for only 2% of cases. Accordingly, the prenatal diagnosis of lymphangioma of the lower limbs has been scarcely reported. This study describes two cases of lymphangioma of the lower limbs, focusing on unique sonographic features and the natural course of rapidly progressive changes, which is different from nuchal lymphangioma. Based on previous isolated case reports together with our two cases, lymphangioma of the lower limbs usually develops in the second trimester, tends to have rapidly progressive changes, and is unlikely to be associated with aneuploidy and structural anomalies. Diagnoses can be made by using sonographic findings pertaining to the subcutaneous complex and multi-septate anechoic cystic lesions in the lower limbs, the latter of which can infiltrate visceral structures. Prenatal detection can be helpful in laying the groundwork for providing counseling to the parents and the planning of management strategies, i.e., opting to terminate the pregnancy, revising delivery plans, and looking towards the postnatal management of the infant.
淋巴管瘤是一种先天性异常，其中异常的淋巴引流定位形成良性肿块，但它有体积增大的趋势，并有可能浸润周围结构，造成破坏性影响并导致严重的发病情况。淋巴管瘤最常见的部位是颈部（颈部囊状水瘤），而下肢淋巴管瘤非常罕见，仅占病例的2%。因此，下肢淋巴管瘤的产前诊断鲜有报道。本研究描述了两例下肢淋巴管瘤病例，重点关注独特的超声特征以及快速进展变化的自然病程，这与颈部淋巴管瘤不同。基于之前的孤立病例报告以及我们的两例病例，下肢淋巴管瘤通常在孕中期发病，倾向于快速进展变化，并且不太可能与非整倍体和结构异常相关。通过使用与下肢皮下复合性多分隔无回声囊性病变相关的超声检查结果可以做出诊断，后者可浸润内脏结构。产前检测有助于为向父母提供咨询以及制定管理策略奠定基础，即选择终止妊娠、修改分娩计划以及考虑婴儿的产后管理。
