Treatment of hemolymphangioma by robotic surgery: A case report

BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.

Giant retroperitoneal hemolymphangioma:A case report and review of literature

BACKGROUND Hemolymphangioma is a very rare benign tumor in clinical practice caused by abnormalities of the vasculature.Its clinical features are often atypical,and it is easy to miss and misdiagnose.When the time of nuclear magnetic T1 is significantly reduced,the diagnosis of hemangioma should be considered.Therefore,we report this case in the hope of raising clinicians'awareness of the disease.CASE SUMMARY A 37-year-old man presented with a giant retroperitoneal hemolymphangioma.Computed tomography and magnetic resonance imaging indicated the possibility of a large perirenal lymphatic cyst.The postoperative pathological diagnosis is retroperitoneal hemolymphangioma.The patient underwent surgical excision after adequate drainage.The postoperative recovery was smooth and there were no complications.There was no recurrence during half a year of follow-up.CONCLUSION This case reiterates that large retroperitoneal cystic masses with significantly shortened nuclear T1 time should be considered hemolymphangioma.Specific clinical basis and experience for the diagnosis and treatment of these diseases is necessary.

Rare giant intradural epidural hemolymphangioma:A case report

BACKGROUND Hemolymphangioma is a rare,noninvasive benign tumor that originates from vascular and lymphatic malformations.It is usually congenital and can present with varying symptoms depending on its location and size.There are very few reports of hemolymphangiomas within the spinal canal,and giant lesions are exceptionally rare.CASE SUMMARY In July 2023,a 64-year-old male with a giant intravertebral epidural hemolymphangioma from thoracic 11 to lumbar 2(T11-L2)was admitted to the Department of Spine Surgery at the People's Hospital of Binzhou City,China.The patient experienced progressive lumbar and left lower limb pain,numbness,weakness in both lower limbs,and difficulty with urination and defecation.Imaging studies revealed a large cystic mass in the spinal canal at T11-L2.Surgical decompression was performed,and the pathology confirmed hemolymphangioma.CONCLUSION Complete resection of hemolymphangiomas has the best prognosis,and final diagnosis relies on pathologic diagnosis.In this case,the mass was removed intact with a pedicle nail rod system,leading to adequate spinal decompression and restoration of spinal stability.

Hemolymphangioma: A rare differential diagnosis of cystic-solid or cystic tumors of the pancreas

We report a case of pancreatic hemolymphangioma. Hemolymphangioma is a malformation of both lymphatic vessels and blood vessels. The incidence of this disease in the pancreas is extremely rare. To the best of our knowledge, only seven cases have been reported worldwide (PubMed). A 39-year-old woman with a oneday history of abdominal pain was admitted to our hospital. There was no obvious precipitating factor. The preoperative examination, including ultrasonography and computed tomography, showed a cystic-solid tumor in the pancreas, and it was considered to be a mucinous cystadenoma or cystadenocarcinoma. Pancreaticbody-tail resection combined with splenectomy was performed. After the operation, the tumor was pathologically demonstrated to be a pancreatic hemolymphangioma. Although pancreatic hemolymphangioma is rare, we believe that it should be considered in the differential diagnosis of cystic-solid tumors of the pancreas, particularly when there is no sufficient evidence for diagnosing cystadenoma, cystadenocarcinoma or some other relatively common disease of the pancreas.

A case of invasive hemolymphangioma of the pancreas

Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding.

Diffuse hemolymphangioma of the rectum: A report of a rare case

Intestinal hemolymphangioma is a rare vascular and lymphatic malformation and is manifested as anaemia and recurrent alimentary tract hemorrhage. Few cases of hemolymphangioma occurring in small intestine, spleen, esophagus and other organs have been reported. We herein report a case of a 37-year-old man with severe rectal bleeding. Digital examination revealed nodular mucosa. No rectal mass was palpated, but bleeding in the ampulla was detected. Colonoscopy revealed an extensive hypervascular submucosal lesion arising from the rectosigmoid junction colon to the distal edge of the anus. Endoscopic ultrasonography demonstrated an extensive anechoic mass with clear edge. Magnetic resonance imaging (MRI) showed a significant thickness of the rectal wall, extending to the distal edge of the anus, with a narrowing lumen. A sphinctersaving rectal surgery was performed. Due to a lack of knowledge of the clinical, endoscopic and radiological features, preoperative recognition of hemolymphangioma is not easy. Computed tomography and MRI are helpful in confirming the diagnosis, and defining the extent and invasion of the lesion. For the low malignant potential tumors, a sphincter-saving rectal surgery is recommended after a full evaluation of the tumor.

Hemolymphangioma of the spleen:A report of a rare case

Hemolymphangioma is a malformation of both lymphatic vessels and blood vessels.Splenic hemolymphangioma is extremely rare.Herein,we present a case of 62-yearold woman with ambiguous upper quadrant abdominal pain for two months who was found to have an occupying lesion in the spleen on computed tomography.She was eventually diagnosed with hemolymphangioma of the spleen.The patient underwent total splenectomy.Neither symptoms nor recurrence was found during the one-year follow-up period.

Small intestinal hemolymphangioma treated with enteroscopic injection sclerotherapy: A case report and review of literature

BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often presents as obscure gastrointestinal bleeding.It is rarely diagnosed correctly before the operation.Endoscopic injection sclerotherapy is usually used as a management of bleeding in esophageal varices and was occasionally reported as a treatment of vascular malformation.The treatment of small intestinal hemolymphangioma with enteroscopic injection sclerotherapy has not been reported.CASE SUMMARY A 42-year-old male complained of recurrent episodes of melena and dizziness,fatigue and reduced exercise capacity for more than 2 mo.Gastroduodenoscopy and blood test revealed a gastric ulcer and anemia.Treatment with oral protonpump inhibitors and iron did not improve symptoms.We then performed a capsule endoscopy and anterograde balloon-assisted enteroscopy and revealed a hemolymphangioma.Considering it is a benign tumor without malignant potential,we performed enteroscopic injection sclerotherapy.He was discharged 4 days later.At follow-up 3 mo later,the melena disappeared.Balloon-assisted enteroscopy revealed an atrophied tumor atrophied and no bleeding.Argon plasma coagulation was applied to the surface of the hemolymphangioma to accelerated healing.When he returned for follow-up 1 year later,anemia was resolved and the tumor had been cured.CONCLUSION Balloon-assisted enteroscopy and capsule endoscopy are effective methods for diagnosis of hemolymphangioma.Enteroscopic injection sclerotherapy is an effective treatment.

Small intestinal hemolymphangioma with bleeding:A case report

Small intestinal hemolymphangioma is a very rare benign tumor.There was only one report of a hemolymphangioma of the pancreas invading to the duodenum until March 2011.Here we describe the first case of small intestinal hemolymphangioma with bleeding in a 57-year-old woman.She presented with persistent gastrointestinal bleeding and endoscopy revealed a small intestinal tumor.Partial resection of the small intestine was thus performed and the final pathological diagnosis was hemolymphangioma.We also highlight the difficultly in making an accurate preoperative diagnosis in spite of modern imaging techniques.To arrive at a definitive diagnosis and exclude malignancy,partial resection of the small intestine was considered to be the required treatment.

Paraspinous hemolymphangioma associated with adolescent scoliosis

Lymphangiomas are a group of benign malformations of the lymphatic system, and hemolymphangioma(or hemangiolymphangioma) is a rare congenital malformation of the lymphatic system with vascular involvement. These benign malformations are most commonly diagnosed at an early age, and may be present as a part of an associated syndrome. In this case report, we describe the first case of adolescent scoliosis associated with a large, paraspinous hemolymphangioma. A 15-year-old girl with an incidental finding of a paraspinous hemolymphangioma is presented along with her history, physical exam, radiographic findings, and operative course. The possible pathogenesis, treatment approach, and clinical dilemmas are also discussed. Given the well-known relationship between tumors and scoliosis, a benign paraspinous vascular and lymphatic tumor may be responsible for the presence of scoliosis in a small number of patients.

Hemolymphangioma with multiple hemangiomas in liver of elderly woman with history of gynecological malignancy: A case report

BACKGROUND Hepatic hemolymphangioma is an extremely rare benign congenital malformation composed of cystically dilated lymphatic and blood vessels,and they have nonspecific clinical symptoms and laboratory results.In this study,hepatic hemolymphangioma with multiple hemangiomas in an elderly woman was initially reported and analyzed.CASE SUMMARY A 61-year-old female patient,with a history of hysterectomy and bilateral adnexectomy,was referred to the hepatobiliary surgery department with the complaint of multiple hepatic hemangiomas that had been diagnosed 2 years prior in a preoperative contrast-enhanced computed tomography(CECT)examination.Upon entering our hospital,no abnormal physical examination and laboratory data were found.The latest CECT revealed a new 7.0 cm×6.2 cm cystic-solid lesion with multiple internal divisions in segment II of the liver,with delayed CECT enhancement characteristics that presented as solid parts with internal division.On the positron emission tomography(PET)/CT,no significant uptake of 18F-fluorodeoxyglucse was observed.Finally,hepatic hemolymphangioma was confirmed based on the pathological and immunohistochemical results after surgery.At 1-year follow-up,her posthepatectomy evaluation was uneventful,and she had recovered full activity.In addition,no postoperative recurrent or residual lesion was found on CECT imaging.CONCLUSION Hepatic hemolymphangioma with multiple hemangiomas was reported and observed by CECT and PET/CT imaging.

胸段椎管内硬膜外血管淋巴管瘤并血栓形成1例

患者男,58岁,因＂胸背部疼痛,双下肢无力伴感觉减退1天＂入院;经脱水治疗后胸背部疼痛感消失,但双下肢无力伴感觉减退逐渐加重。查体：双上肢肌力V级,双下肢肌力0级,肌张力正常,T6水平以下深、浅感觉减退,T4～T6椎体水平压痛。MRI：T3～T4水平椎管内见2.5cm×1.5cm块状等及稍短T1（图1A）、稍长及稍短T2异常信号.

血管淋巴管瘤的CT及MRI诊断

目的探讨血管淋巴管瘤的CT及MRI表现,提高对本病的认识。方法搜集经手术病理证实的血管淋巴管瘤12例,其中CT扫描2例,MRI扫描11例。回顾性分析血管淋巴管瘤的影像学特点。结果 12个病例中多房囊性或囊实性11例,均以囊性为主;单房囊性1例;沿组织间隙蔓延生长11例;MRI显示液-液平2例。CT或MR增强扫描囊壁及间隔轻度或中重度强化。结论血管淋巴管瘤多呈多房囊性或囊实性,以囊性为主,易沿疏松组织间隙蔓延,影像学表现具特征性。

胰腺血管淋巴管瘤CT表现(附1例报告及文献回顾)

脉管瘤是一种起源于间胚叶组织、生长缓慢的良性肿瘤,因其含血管和淋巴管成分又称为血管淋巴管瘤[1],最常见于头颈部[2],发生在胰腺的血管淋巴管瘤较为罕见,目前仅见17例相关个案报道。本文通过分析1例胰腺血管淋巴管瘤的CT表现及临床资料,结合国内外相关文献进行总结,旨在提高本病术前CT诊断的准确性。

空肠血管淋巴管瘤1例报道及文献复习

目的:报道1例空肠血管淋巴管瘤,结合文献探讨其临床病理学特征及诊断要点。方法:对1例空肠血管淋巴管瘤进行临床病理分析及免疫组化观察。结果:空肠血管淋巴管瘤无特殊临床表现及肠镜特点,镜下黏膜及黏膜下层查见大量大小不一的薄壁管腔,腔内壁衬覆单层扁平内皮,部分管腔扩张充血,部分管腔内充满淋巴液并含有淋巴细胞。免疫组化表型:淋巴管瘤CD31、CD34和D2-40均阳性,而血管瘤CD31、CD34阳性、D2-40阴性。结论:血管淋巴管瘤是一种少见的良性肿瘤,发生于胃肠道尤其是空肠的血管淋巴管瘤极为少见,小肠镜检查及临床特征与恶性肿瘤难以鉴别,需要结合病理学检查确定诊断。

纵隔血管瘤及淋巴管瘤的MSCT表现

目的:探讨纵隔血管瘤及淋巴管瘤的MSCT表现,提高对此类疾病的影像诊断水平。方法:搜集15例经病理证实的纵隔血管瘤及淋巴管瘤,回顾性分析其CT表现。结果:血管瘤4例,表现为纵隔软组织肿块,边界清晰,密度可均匀或不均匀,静脉石为其特征性表现,增强扫描呈渐进性强化或延迟强化。淋巴管瘤7例,表现为纵隔均匀低密度灶,可包绕纵隔结构或沿纵隔大血管间隙弥漫生长,增强扫描呈囊性不强化或仅囊壁及分隔轻度强化。血管淋巴管瘤4例,表现变异较大,以血管瘤为主者表现为软组织肿块,密度多不均匀,增强扫描实性成分与静脉强化相似;以淋巴管瘤为主者表现为低密度灶内可见静脉成分(静脉石或小血管影)。结论:CT对纵隔血管瘤及淋巴管瘤的诊断具有重要价值,在指导临床治疗中发挥重要作用。

椎管内硬膜外脉管瘤1例报告并文献复习

目的 探讨椎管内脉管瘤的临床、影像学表现及治疗方式。方法 回顾性分析1例椎管内硬膜外脉管瘤患者的临床资料,并对相关文献进行复习。结果 本例男性患者,24岁,无明显诱因突然起病,临床表现为反复发作的背部酸胀痛,每次持续时间数小时至几天不等,随疾病进展,逐渐出现双下肢麻木症状;MRI检查示,T平椎管内占位性病变,呈以稍等T长T信号。予患者介入栓塞结合开放手术治疗,全切肿瘤,术后患者临床症状完全消失,未遗留神经损害后遗症。术后病理检查示,脉管瘤伴混合血栓形成。结论椎管内的脉管瘤极为少见,影像学检查可提供明确的定位诊断,但定性诊断仍依靠病理活检。介入栓塞治疗结合开放手术切除病变可以大幅降低出血风险,减小开放手术难度。全切肿瘤,可防止严重神经功能损害,降低复发率,明显改善患者预后。

肝脾血管淋巴管瘤磁共振成像的影像学表现

目的:探讨肝、脾血管淋巴管瘤的磁共振成像(MRI)影像特征及诊断要点,提高对该病的认识。方法:采用回顾性分析方法对2例经手术病理证实的肝、脾多发血管淋巴管瘤的MRI影像表现进行分析总结,并与其病理诊断结果进行对照。结果:肝、脾多发血管淋巴管瘤的MRI影像表现为肝、脾内见多发类圆形囊状长T1混杂长T2信号影,囊内可见分隔、呈大小不一多房样改变,增强扫描动脉期病灶边缘及囊内见散在条索样及线样分隔状强化影,门脉期及延迟期强化尤为明显。病理学表现为肝内及脾内囊实性肿块,镜下见较多淋巴管、血管,MRI影像表现与病理学表现一致;免疫组织化学病理诊断CD34(+),CD31(+),LCA(+)。结论:肝、脾血管淋巴管瘤临床上极其罕见,缺乏典型临床症状和体征,MRI对其具有重要诊断价值,可为指导临床治疗提供帮助。

胰腺血管淋巴管瘤的诊断

血管淋巴管瘤是比较少见的淋巴管和微静脉的混合畸形，累及胰腺的血管淋巴管瘤更为罕见。本研究通过总结该病的影像学检查表现，旨在提高该病影像学诊断的准确性。