肝囊性淋巴管瘤2例报告并国内文献回顾
| 作者: |
1杨永光,
2刘丽娟,
3谌力群,
1田猛,
1曾连山,
1陈念平,
1谭小宇,
1李明意
1 广东医科大学附属医院肝胆外科，广东 湛江 524001 2 广东医科大学附属医院超声科，广东 湛江 524001 3 广东医科大学附属湛江肿瘤医院 放射科，广东 湛江 524001 |
| 通讯: |
杨永光
Email: nmgyyg@163.com |
| DOI: | 10.3978/.2018.01.016 |
摘要
目的：探讨肝囊性淋巴管瘤的临床特点和诊治方法，以提高诊断率及治疗效果。
方法：回顾性分析广东医科大学附属医院收治的2例成人肝囊性淋巴管瘤患者临床资料及诊疗过程，并检索、复习中文期刊数据库中肝囊性淋巴管瘤的文献。
结果：笔者收治的2例患者，均为女性，入院诊断分别为肝囊性占位和肝囊肿；患者完善相关检查后行肝切除术，术后病理诊断肝囊性淋巴管瘤；患者术后随访均无复发，治疗满意。检索1984—2017年期间国内共报道6例患者，其中男4例，女2例；入院诊断肝囊淋巴管瘤2例（2/6）；其他均误诊（4/6），6例患者均行手术切除后明确诊断，术后患者恢复满意。
结论：肝囊性淋巴管瘤为临床罕见的肝脏良性疾病。临床症状、体征及影像学表现无特异性，临床易误诊为肝囊肿及其他囊性疾病；MRl有助于鉴别诊断；有明确症状、体征或不能排除恶性的患者应结合个体情况制定治疗方案，病理检查是明确诊断的唯一方法。
关键词：
肝；淋巴管瘤，囊状/诊断；淋巴管瘤，囊状/治疗
方法：回顾性分析广东医科大学附属医院收治的2例成人肝囊性淋巴管瘤患者临床资料及诊疗过程，并检索、复习中文期刊数据库中肝囊性淋巴管瘤的文献。
结果：笔者收治的2例患者，均为女性，入院诊断分别为肝囊性占位和肝囊肿；患者完善相关检查后行肝切除术，术后病理诊断肝囊性淋巴管瘤；患者术后随访均无复发，治疗满意。检索1984—2017年期间国内共报道6例患者，其中男4例，女2例；入院诊断肝囊淋巴管瘤2例（2/6）；其他均误诊（4/6），6例患者均行手术切除后明确诊断，术后患者恢复满意。
结论：肝囊性淋巴管瘤为临床罕见的肝脏良性疾病。临床症状、体征及影像学表现无特异性，临床易误诊为肝囊肿及其他囊性疾病；MRl有助于鉴别诊断；有明确症状、体征或不能排除恶性的患者应结合个体情况制定治疗方案，病理检查是明确诊断的唯一方法。
Cystic hepatic lymphangioma: a report of two cases with domestic literature review
CorrespondingAuthor:YANG Yongguang Email: nmgyyg@163.com
Abstract
Objective: To investigate the clinical features of cystic hepatic lymphangioma and its diagnosis and treatment methods, so as to improve the diagnostic rate and therapeutic efficacy.
Methods: The clinical data as well as diagnosis and treatment process of two adult patients with cystic hepatic lymphangioma in Affiliated Hospital of Guangdong Medical University were retrospectively analyzed. The literature on cystic hepatic lymphangioma in periodical databases was retrieved and reviewed.
Results: Both patients treated by the authors were female, and were diagnosed as cystic space occupying lesion of the liver and hepatic cyst on admission respectively; then both patients received surgical treatment after completion of the relevant examinations, and were finally diagnosed as cystic hepatic lymphangioma by postoperative pathology; no recurrence occurred in either of them during follow-up and the treatment results were satisfactory. A total of 6 patients with cystic hepatic lymphangioma were reported in China from 1984 to 2017, of whom, 4 cases were male and 2 cases were female; two cases were diagnosed as hepatic cystic lymphangioma (2/6) and all the others (4/6) were misdiagnosed at admission. After surgical resection, the diagnosis was confirmed to be cystic hepatic lymphangioma in all of the 6 cases and they all recovered satisfactorily after operation.
Conclusion: Cystic hepatic lymphangioma is a rare benign liver disease, which has no specific clinical symptoms, signs and imaging characteristics, and is likely to be misdiagnosed as liver cysts and other cystic diseases of the liver in clinical practice. MRI can help in differential diagnosis. Treatment plan should be based on the individual conditions of the patients with definite symptoms and signs or if malignancy cannot be excluded. Pathological examination is the only way to make the definite diagnosis.
Keywords：
Liver; Lymphangioma
Cystic/diag; Lymphangioma
Cystic/ther
Methods: The clinical data as well as diagnosis and treatment process of two adult patients with cystic hepatic lymphangioma in Affiliated Hospital of Guangdong Medical University were retrospectively analyzed. The literature on cystic hepatic lymphangioma in periodical databases was retrieved and reviewed.
Results: Both patients treated by the authors were female, and were diagnosed as cystic space occupying lesion of the liver and hepatic cyst on admission respectively; then both patients received surgical treatment after completion of the relevant examinations, and were finally diagnosed as cystic hepatic lymphangioma by postoperative pathology; no recurrence occurred in either of them during follow-up and the treatment results were satisfactory. A total of 6 patients with cystic hepatic lymphangioma were reported in China from 1984 to 2017, of whom, 4 cases were male and 2 cases were female; two cases were diagnosed as hepatic cystic lymphangioma (2/6) and all the others (4/6) were misdiagnosed at admission. After surgical resection, the diagnosis was confirmed to be cystic hepatic lymphangioma in all of the 6 cases and they all recovered satisfactorily after operation.
Conclusion: Cystic hepatic lymphangioma is a rare benign liver disease, which has no specific clinical symptoms, signs and imaging characteristics, and is likely to be misdiagnosed as liver cysts and other cystic diseases of the liver in clinical practice. MRI can help in differential diagnosis. Treatment plan should be based on the individual conditions of the patients with definite symptoms and signs or if malignancy cannot be excluded. Pathological examination is the only way to make the definite diagnosis.