Levien L J, Benn C A
Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
J Vasc Surg. 1998 Aug;28(2):193-205. doi: 10.1016/s0741-5214(98)70155-7.
Six cases of adventitial cystic disease were studied, and the existing theories of the aetiology of adventitial cystic disease were reviewed to present evidence in support of a variation of the developmental hypothesis that might explain the sites of occurrence of this rare condition.
Cases of adventitial cystic disease were collected by interrogation of the records of a group of vascular surgeons in the Johannesburg area. After reviewing the relevant literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and the theories of the formation of adventitial cystic disease were reviewed. The embryological origin of those vessels in which adventitial cystic disease occurs was investigated. Clinical cases were collected in private practice vascular referral centers. The clinical features, treatment, and subsequent course of six cases of adventitial cystic disease (four related to the popliteal artery, one in the femoral artery, and one in the radial artery) are included.
All cases of adventitial cystic disease reported have occurred in the nonaxial arteries, which form at a later stage than the axial vessels during limb differentiation and development. It is therefore postulated that during limb bud development cell rests derived from condensations of mesenchymal tissue destined to form the knee, hip, wrist, or ankle joints are incorporated into the nearby and adjacent nonaxial vessels during development of these vessels in the 15-22-week stage. These newly forming nonaxial vessels develop from vascular plexuses during the same stage of development, and in close proximity to the adjacent condensing joint structures. It is further postulated that these cell rests are then responsible for the formation of adventitial cystic disease later in life, when the mucoid material secreted results in a mass lesion within the arterial or venous wall.
There is evidence supporting the hypothesis that adventitial cystic disease is a developmental condition occurring in the nonaxial blood vessels.
对6例外膜囊肿性疾病进行研究，并回顾现有的外膜囊肿性疾病病因理论，以提供证据支持一种发育假说的变体，该变体可能解释这种罕见病症的发病部位。
通过查阅约翰内斯堡地区一组血管外科医生的记录来收集外膜囊肿性疾病病例。在回顾相关文献后，记录了323例外膜囊肿性疾病的发病部位，并对外膜囊肿性疾病的形成理论进行了回顾。研究了发生外膜囊肿性疾病的血管的胚胎起源。临床病例收集自私人执业血管转诊中心。纳入了6例外膜囊肿性疾病（4例与腘动脉相关，1例在股动脉，1例在桡动脉）的临床特征、治疗及后续病程。
所有报道的外膜囊肿性疾病病例均发生在非轴性动脉，这些动脉在肢体分化和发育过程中比轴性血管形成得晚。因此推测，在肢芽发育过程中，源自注定形成膝关节、髋关节、腕关节或踝关节的间充质组织凝聚的细胞残余，在这些血管于15 - 22周阶段发育过程中被纳入附近和相邻的非轴性血管。这些新形成的非轴性血管在发育的同一阶段从血管丛发育而来，且紧邻相邻的凝聚关节结构。进一步推测，这些细胞残余在生命后期负责形成外膜囊肿性疾病，此时分泌的黏液物质在动脉或静脉壁内形成肿块病变。
有证据支持外膜囊肿性疾病是一种发生在非轴性血管的发育性病症这一假说。
