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胎儿胸腰段淋巴管瘤的产前诊断与鉴别诊断

Prenatal and differential diagnosis of fetal thoracolumbar lymphangioma.

作者信息

Sandoval Quiñonez Paúl Alberto, Osuna Álvarez Óscar, Castro Apodaca Francisco Javier, Sisti Giovanni

机构信息

Fetal Diagnostic Center, Los Mochis Sinaloa, Mexico.

Old Civil Hospital of Guadalajara "Fray Antonio Alcadel", Guadalajara, Jalisco, Mexico.

出版信息

BMJ Case Rep. 2025 Apr 23;18(4):e263811. doi: 10.1136/bcr-2024-263811.

Abstract

We present a case of a woman in her mid-30s at 21 weeks of gestation referred to our tertiary medical center by an outside clinic with an ultrasound finding of a cystic septated lesion on the left side of the fetal chest.The differential diagnosis included, among others, foetal nuchal oedema, cystic hygroma, meningocele, encephalocele, cervical teratoma, haemangioma and subchorionic placental cyst. The sonographic finding of lack of intralesional vascularity on Doppler, seemingly without communication with the spinal canal, pointed us towards a diagnosis of foetal cystic lymphangioma. Our diagnosis was confirmed postnatally.Foetal cystic lymphangiomas are rare benign congenital tumours of the vascular and lymphatic systems. The differential diagnosis is broad, and a timely diagnosis positively affects the prognosis. If a lymphangioma is suspected, we suggest referral to specialists in maternal-foetal medicine with expertise in the field.

摘要

我们报告了一例35岁左右、孕21周的女性病例,该患者由一家外部诊所转诊至我们的三级医疗中心,超声检查发现胎儿胸部左侧有一个囊性分隔病变。鉴别诊断包括胎儿颈部水肿、囊性水瘤、脊膜膨出、脑膨出、颈部畸胎瘤、血管瘤和绒毛膜下胎盘囊肿等。多普勒超声显示病变内部无血管,且似乎与椎管无连通,这一超声表现使我们倾向于诊断为胎儿囊性淋巴管瘤。我们的诊断在产后得到了证实。胎儿囊性淋巴管瘤是血管和淋巴系统罕见的良性先天性肿瘤。鉴别诊断范围广泛,及时诊断对预后有积极影响。如果怀疑是淋巴管瘤,我们建议转诊至在该领域有专业知识的母胎医学专家处。

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