静脉内平滑肌瘤病误诊为下腔静脉血栓形成1例及文献回顾

A Case Of Intravenous Leiomyomatosis Misdiagnosed as In Inferior Vena Cava Thrombosis And Literature Review

目的分析静脉内平滑肌瘤病(IVL)的发病机制,临床表现以及影像学特点,提高该疾病的检出率及完整切除率。方法对南充市中心医院2019年11月收治的一例LVL患者进行分析,并复习相关文献,总结本疾病的临床特点及诊疗方法。结果该患者曾被误诊为下腔静脉血栓形成并置入下腔静脉滤器,由于滤器阻塞,瘤体生长方式特殊。该疾病临床表现缺乏特异性,影像学检查误诊、漏诊率高,肿瘤进入右心系统后,手术切除难度大大增加。结论充分认识该病影像学表现是提高诊断率的关键,手术是否完整切除为影响其预后的最重要因素。

Objective Analyze the pathogenesis,clinical manifestations and imaging characteristics of intravenous leiomyomatosis,and improve the detection rate and complete resection rate of the disease.Methods This study retrospectively analyzed an LVL patient admitted to Nanchong Central Hospital in November 2019 and reviewed related literature.Results The patient was misdiagnosed as inferior vena cava thrombosis and inserted an inferior vena cava filter.The tumor grew in a special way due to the obstruction of the filter.The clinical manifestations of the disease lack specificity,and the rate of misdiagnosis and missed diagnosis in imaging examinations is high.After the tumor enters the right ventricular system,it is more difficult to be completely resected.Intravenous leiomyomatosis;Inferior vena cava thrombosis.Conclusions Fully understanding the imaging manifestations of the disease is the key to improving the diagnosis rate,and whether the operation is completely resected is the most important factor affecting its prognosis.