Zhang Yan, Hao Qi, Li Xingpeng, Liu Mengke, Sun Xiaoli, Wang Rengui
Department of Radiology, Qilu Hospital of Shandong University, Jinan, China.
Department of Radiology, Peking University People's Hospital, Beijing, China.
Quant Imaging Med Surg. 2025 Jun 6;15(6):5567-5581. doi: 10.21037/qims-24-1252. Epub 2025 May 30.
Complex lymphatic anomaly is a type of lymphatic malformation involving multiple organs and systems, and its clinical and imaging manifestations are varied. The aim of this study was to retrospectively analyze the clinical and imaging features of conventional computed tomography (CT) and CT lymphangiography in patients with thoracic complex lymphatic anomaly. Further, we aimed to explore the imaging features and differences among different subtypes of thoracic complex lymphatic anomaly (generalized lymphatic anomaly, Gorham-Stout disease, central conducting lymphatic anomaly).
This study enrolled 119 patients with thoracic complex lymphatic anomaly in Beijing Shijitan Hospital, Capital Medical University (Peking University Ninth School of Clinical Medicine) from January 2017 to December 2020. The differences in gender, symptoms, lesion location, lesion morphology, and abnormal deposition of lipiodol among the three types of thoracic complex lymphatic anomaly were compared. Chi-square test or Fisher's exact test was used, and Bonferroni test was used for pairwise comparison.
Among the 119 patients with thoracic complex lymphatic anomaly, 67 patients had generalized lymphatic anomaly, 21 patients had Gorham-Stout disease, and 31 patients had central conducting lymphatic anomaly. There were significant differences in the age (P=0.005), limb swelling (P=0.009), diarrhea (P<0.001), involvement of lung (P=0.004), mediastinum (P=0.026), abdominopelvic wall (P=0.014), spleen (P=0.020), bone (P<0.001), cystic lesions (P=0.001), and diffuse swelling lesions (P=0.023) among the three groups. Abnormal deposition of lipiodol was most common at the end of the thoracic duct.
The different types of thoracic complex lymphatic anomaly have different clinical and imaging manifestations. Conventional chest CT and CT lymphangiography can provide imaging information for the diagnosis of different types of patients, which is conducive to accurate diagnosis and treatment.
复杂性淋巴管异常是一种累及多个器官和系统的淋巴管畸形，其临床和影像学表现多样。本研究旨在回顾性分析胸部复杂性淋巴管异常患者的传统计算机断层扫描（CT）及CT淋巴管造影的临床和影像学特征。此外，我们旨在探讨胸部复杂性淋巴管异常不同亚型（广泛性淋巴管异常、戈勒姆-斯托特病、中央传导性淋巴管异常）的影像学特征及差异。
本研究纳入了2017年1月至2020年12月在首都医科大学附属北京世纪坛医院（北京大学第九临床医学院）就诊的119例胸部复杂性淋巴管异常患者。比较了三种类型胸部复杂性淋巴管异常在性别、症状、病变部位、病变形态及碘油异常沉积方面的差异。采用卡方检验或Fisher精确检验，两两比较采用Bonferroni检验。
119例胸部复杂性淋巴管异常患者中，67例为广泛性淋巴管异常，21例为戈勒姆-斯托特病，31例为中央传导性淋巴管异常。三组在年龄（P = 0.005）、肢体肿胀（P = 0.009）、腹泻（P < 0.001）、肺部受累（P = 0.004）、纵隔受累（P = 0.026）、腹盆腔壁受累（P = 0.014）、脾脏受累（P = 0.020）、骨骼受累（P < 0.001）、囊性病变（P = 0.001）及弥漫性肿胀病变（P = 0.023）方面存在显著差异。碘油异常沉积最常见于胸导管末端。
不同类型的胸部复杂性淋巴管异常具有不同的临床和影像学表现。传统胸部CT及CT淋巴管造影可为不同类型患者的诊断提供影像学信息，有助于准确诊断和治疗。
