胎儿右侧腋下胸壁巨大淋巴管畸形的宫内外治疗一例

Intra-and extrauterine treatment for giant fetal axilla-thoracic cystic lymphangioma:a case report

胎儿淋巴管畸形是淋巴系统异常发育性疾病,可发生在全身任何部位,颈部常见,其次为腋下。本文报告1例胎儿右侧腋下胸壁淋巴管畸形的病例。该病例孕21周常规超声检查时确诊胎儿右侧腋下胸壁淋巴管畸形,大小21 mm×18 mm×16 mm,后每隔4周复查超声,团块进行性增大,至37周^(+4)右侧腋下胸壁淋巴管畸形增大至101 mm×110 mm×95 mm,38周^(+4)时行超声引导下宫内胎儿囊性团块穿刺抽液术并注入博来霉素治疗,出生后42 d再次行博来霉素治疗。随访至生后10个月时,患儿右侧腋下胸壁未见明显囊性团块。

Fetal cystic lymphangioma is a developmental anomaly of the lymphatic system,which can occur in any part of the body,but most commonly in the neck and armpit.A case of fetal cystic lymphangioma located at the chest wall under the right armpit with a size of 21 mm×18 mm×16 mm is reported here.The mass was initially diagnosed by routine ultrasound examination at 21 gestational weeks.After the diagnosis,ultrasound was repeated every 4 weeks till 37^(+4) gestational weeks.Over this period,the mass increased progressively to 101 mm×110 mm×95 mm.Ultrasound-guided intrauterine fetal cystic mass puncture and aspiration was performed 38^(+4) weekss,and Bleomycin was injected into the cyst after operation and on day 42 after birth.During a follow-up to 10 months after birth,no obvious cystic mass was found at the right axillary chest wall of the child.