成人颈部淋巴管瘤25例临床分析

Clinical analysis of 25 cases of adult cervical lymphangioma

目的探讨成人颈部淋巴管瘤的临床特征、诊断、治疗及预后。方法对北京世纪坛医院淋巴外科2017年2月至2020年6月收治的成人颈部淋巴管瘤病例进行回顾性分析。结果25例成人颈部淋巴管瘤患者中,男5例,女20例,年龄18~58岁。25例行核素淋巴显像检查,其中8例可见颈部肿物区域放射性增高表现;17例行直接淋巴管造影检查,14例发现颈段胸导管出口梗阻。手术治疗21例,随访6~47个月,无1例复发;未行手术治疗4例,1例失访,另3例随访16~48个月,颈部肿物有不同程度进展。结论成人颈部淋巴管瘤是一种淋巴管畸形疾病,完整切除肿物以及改善胸导管通畅性是治疗的关键。

Objective To investigate the clinical features,diagnosis,treatment and prognosis of adult cervical lymphangioma.Methods Twenty-five cases of adult cervical lymphangioma admitted at Department of Lymphatic Surgery of Beijing Shijitan Hospital from Feb 2017 to Jun 2020 were retrospectively analyzed.Results Among the 25 cases,there were 5 males and 20 females,aged from 18 to 58 years.Radionuclide lymphoscintigraphy performed in 25 cases,increased radioactivity in the neck tumor area was seen in 8 cases;Direct lymphangiography performed in 17 cases,outlet obstruction of cervical thoracic duct was found in 14 cases.Twenty one cases were treated by operation and followed up for 6-47 months.No recurrence was found;4 cases abandoned surgery,1 case was lost to follow-up,and the other 3 cases were followed up for 16-48 months with tumor progresses.Conclusions Adult cervical lymphangioma is lymphangiomalformation disease.Total resection of the tumor and avoiding damage to the thoracic duct is the key for successful management.