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Abstract: The article presents literature data about splenic lesions, their morphological characteristics and occurrence. Methods of diagnostics of such lesions are considered. Rarely met pathology as lymphangioma of spleen is discussed. Article describes peculiarities of clinical and morphological classifications of lymphangiomas with different locations, their morphological structure, clinical features of this disease in children and adults. Detailed diagnostic algorithm for detection of splenic lymphangioma is described. Possibilities and advantages of modern methods of diagnostic testing, perspective and the leading role CT and MRI are described. Complexities in diagnostics were noted during the research; optimal combinations of diagnostic methods for better verification of such spleen lesions, for estimation of certain anatomical relation with other structures and tissues, spread of the affected area, as well as an assistance in definition of surgical tactics and volume of intervention, based on data were offered. Application of new technologies with the use SCT-dimensional reconstruction of the affected organ and area of further operation, and the 3D planning of intervention, conducting virtual operations for the optimal access, volume of interventions on the base of individual characteristics of vascular and anatomical features of the patient - gives significant advantages. Review of possible treatment methods is presented. As a case report we used obtained data of 26-years woman with identified during ambulatory ultrasound diagnostics lymphangioma of spleen. In conclusion it is pointed that early and accurate diagnostics is important for prevention of complications and for reduce of operational trauma. References 1. Kubyshkin V.A., Ionkin D.A. Opuholi i kisty selezenki [Tumors and cysts of spleen] M.: Medpraktika- M, 2007 [In Russ]. 2. Cappellani A., Zanghi A., Di Vita M. et al. Spontaneous rupture of a giant hemangioma of the liver. Ann. Ital. Chir. 2000; 71: 379-383. 3. Daltrey I.R., Johnson C.D. Cystic lymphangioma of the pancreas. Postgrad. Med. J. 1996; 72(851): 564-566. 4. Panferova T.R. Jehografija v kompleksnoj diagnostike zabrjushinnyh vneorgannyh opuholej u detej . [Ultrasonography in complex diagnostics of retroperitoneal extraorganic tumors in children] Avto-ref. dis. kand. med. nauk. M., 1998 [In Russ]. 5. Brian K.P., Goh M., Y-Meng Tan et al. Intra-abdominal and retroperitoneal ymphangiomas in pediatric and adult patients. WTd J. Surg. 2000; 29: 837-840. 6. Konen O., Rathans V., Dingy E. et al. Childhood abdominal cystic lymphangioma. Pediatr. Radiol. 2002; 32: 88-94. 7. Christie J.P., Karlan M.S. Lymphangioma of the pancreas with symptoms of «acute surgical abdomen». Calif Med. 1969; 111(1): 22-24. 8. Umap P. Intra! abdominal cystic lymphangioma. IndianJ. Cancer 1994; 31: 111-113. 9. Volobuev N.N., Tihonov K.S., Minajkin V.I. Gigantskaja kistoznaja limfangioma brjushnoj polosti. Hirurgija. [Giant cystic lymphangioma of abdominal cavity] 1989;5: 127-128 [In Russ]. 10. Faul J.L., Berry G.J., Colby T.V. et al. Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis and lymphatic dysplasia syndrome. Am. J. Respir. Crit. Care Med. 2000; 161: 1037-1046. 11. Wegner G. Veber Lymphangiome. Arch. Klin. Chir. 1877; 20: 641. 12. Matjunin V.V. Limfangiomy cheljustno-licevoj oblasti u detej. [Lymphangiomas of maxillofacial area in children] Dissertation for degree of Doctor of Philosophy. M., 1993;150 [In Russ]. 13. Takeuchi Y., Fujinami S., Kitagawa S. et al. Laparoscopic observation of retroperitoneal cystic lymphangioma. J. Gastroenterol. Hepatol. 1994; 9(2): 198-200. 14. Bliss D.P. Jr., Coffin C.M., Bower R.J. et al. Mesenteric cysts in children. Surgery. 1994; 115: 571-577. 15. Hancock B.J., St. Vil D., Luks F.I. et al. Complication of lymphangiomas in children. J. Pediatr. Surg. 1992; 27(2): 220-226. 16. Kurtz R.J., Heimann T.M., Holt J. et al. Mesenteric and retroperitoneal cysts. Ann. Swrg. 1986; 203: 109-111. 17. Chou Y.H., Tiu C.M., Lui W.Y. et al. Mesenteric and omental cysts: an ultrasonographic and clinical study of 15 patients. Gastrointest. Radiol. 1991; 16: 311-314. 18. Stepanova Ju.A. Diagnostika neorgannyh zabrjushinnyh obrazovanij po dannym kompleksnogo ul'trazvukovogo issledovanija: [Diagnostics of retroperitoneal newgrowth: complex US diagnostics.] Dissertation for degree of Doctor of Philosophy.M., 2002 [In Russ]. 19. Karmazanovskij G.G., Fedorov V.D. Kompjuternaja tomografija podzheludochnoj zhelezy i organov zabrjuwinnogo prostranstva [CT of pancreas and retroperitoneal organs]. M.: Paganel', 2000 [In Russ]. 20. Melihova M.V. Differencial'no diagnosticheskie vozmozhnosti spiral'noj kompjuternoj tomografii s boljusnym kontrastnym usileniem pri neorgannyh zabrjushinnyh obrazovanijah. [MCST with bolus contrast encashment in differential diagnostics of extraorganic retroperitoneal newgrowth.] Dissertation for degree of Doctor of Philosophy. M., 2005 [In Russ]. 21. Leung T.K., Lee C.M., Shen L.K., Chen Y.Y. Differential diagnosis of cystic lymphangioma of the pancreas based on imaging features. J. Formos. Med. Assoc. 2006; 105(6): 512-517. 22. Khandelwal M., Lichtenstein G., Morris J. et al. Abdominal lymphangioma masquerading as a pancreatic cystic neoplasm. J. Clin. Gastmenterol. 1995; 20: 142-144. 23. Casadei R., Minni F., Selva S. et al. Cystic lymphangioma of the pancreas: anatomoclinical, diagnostic and therapeutic consideration regarding three personal observations and review of the literature. Hepatogastroenterology. 2003; 50(53): 1681-1686
Application of interventional methods in diagnostics and treatment of macro-cystic forms of lymphangiomas
DOI: https://doi.org/10.25512/DIR.2013.07.4.06
For quoting:
Polyaev Yu.A., Petrushin A.V., Garbuzov R.V., Myl'nikov A.A. "Application of interventional methods in diagnostics and treatment of macro-cystic forms of lymphangiomas". Journal Diagnostic & interventional radiology. 2013; 7(4); 63-68.
Abstract: In the treatment of macro-cystic forms of lymphangiomas, puncture methods have great value. Relapses occure in 50% of cases. The cause of lymphangiomas is the accumulation of liquid and spreading of cystic walls. Aim. Was to develop and propose methods of interventional radiology in the diagnosis and treatment of macro-cystic lymphangiomas. Materials and methods. In 2007-2011, in the radiological department of our hospital were examined and treated 31 children with macro-cystic forms of lymphangiomas. The proposed method of treatment was: puncture, catheterization of cyst, aspiration, performance of cystography and then sclerotherapy with 3% solute of Fibro-Vein or ethoxysclerol.Then - inserting active aspiration system into cyst. The system operated for 3-5 days, during which carried constant active aspiration with sclerotherapy sessions. The indications for catheter removal was the end of cyst liquid secretion. In 20 children we performed a single-stage treatment. In 6 - two-staged, and only in 5 cases, after the second phase of treatment, we observed a relapse of the disease, which leaded for the third phase of treatment. Results. Good results were achieved in 15 of 19 children with lymphangioma of the head and neck, satisfactory - in 4 children. Unsatisfactory results were not noticed. In children with lymphangioma of internal organs a good result was achieved in 11 cases of 12. Only in 1 case remained a small residual cavity Conclusion. The method of active aspiration of macro-cystic lymphangiomas showed very good results. The use of techniques of interventional radiology in the diagnosis of macro-cystic forms of lymphangiomas can assess the condition, shape and size of the cyst, and spend the most effective treatment. The use of interventional techniques as an alternative to surgical excision of the lymphangioma can significantly improve the quality of life. References 1. Schwartz R.A., Fern6ndez G. Lymphangioma. Medicine Dermatology [Journal serial online]. 2009. November 13 [cited 2009 Dec 9]. Available at ttp://emedicine.medscape.com/article/1086806-overview. 2. Eijun Itakura & Hidetaka Yamamoto & Yoshinao Oda & Masutaka Furue & Masazumi Tsuneyoshi. VEGF-C and VEGFR- 3. Flanagan B.P., Helwig E.B. Cutaneous lymphangioma. Arch. Dermatol. 1977;113:24-30. 4. Bond J., Basheer M.H., Gordon D. Lymphangioma circumscriptum: pitfalls and problems in definitive management. Dermatol. Surg. 2008;34:271-5. 5. Khan Z.A., Melero-Martin J.M., Wu X. et al Endothelial progenitor cells from infantile hemangioma and umbilical cord blood display unique cellular responses to endostatin. Blood. 2006;108:915-921. 6. Weiss S.W., Goldblum J.R. Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby. St. Louis, MO. 2001.