術前診断しえた後腹膜嚢胞性リンパ管腫の1例 A PREOPERATIVELY DIAGNOSED CASE OF RETROPERITONEAL CYSTIC LYMPHANGIOMA

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後腹膜リンパ管腫は巨大化して初めて症状が出現し,診断,治療されることが多い稀な疾患である.診断には画像診断と穿刺細胞診が有用であるが,術前診断率は約8%と低い.<br> 今回われわれは,無症状のうちに術前診断した後腹膜リンパ管腫の1例を経験したので報告する.症例は60歳女性.人間ドックで異常を指摘され,精査目的に92年1月14日当科を受診した.超音波検査で腹腔内に径22×15×9cm大の多房性嚢胞を認め, CT検査で嚢胞の一部は右腎静脈と下大静脈の背側に存在し,後腹膜起源と考えた.穿刺吸引液はリンパ液様で細胞診ではClass Iであった.以上より後腹膜リンパ管腫と診断し,無症状のため経過観察とした.しかし9月頃より腹痛,嘔吐が出現したため, 10月5日手術を施行した.腫瘤は右側腹腔内に存在し,右腎動静脈周囲の剥離が困難であったが完全摘除した.切除標本は径25×18×6cm大の多胞性嚢胞で,病理組織学的にリンパ管腫と確定診断した.

Retroperitoneal lymphangioma, an uncommon disease, is rarely diagnosed before operation. Its preoperative diagnosing rate is reported to be about 8%. For correct diagnosis, aspiration biopsy cytology as well as imaginings such as ultrasonography, computed tomography and magnetic resonance imaging have proved useful.<br> A 60-year-old woman was seen at the hospital for close examination of an intraabdominal cystic lesion discovered by ultrasonography at a medical checkup. Ultrasonography revealed an intraperitoneal multilobular cyst with the size of 22×18×10cm. Computed tomography showed the same tumor, part of which was located behind the right renal vein and vena cava inferior. This implied that the tumor originated from the retroperitoenum. Aspiration biopsy cytology showed that the tumor had lymphatic liquid and was benign. The definitive diagnosis of retroperitoneal lymphagioma was made. The patient desired no treatment because she was asymptomatic and knew it was benign.<br> Eight months later, however, she was admitted to the hospital for surgery, complaining of intermittent abdominal pain and vomiting. The giant tumor was completely resected with only a little difficulty in dissecting it from the right renal vein and artery from around which it seemed to have originated. Histologically, the cystic tumor was lymphangioma.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 57(8), 2026-2031, 1996-08-25

    Japan Surgical Association

参考文献:  19件中 1-19件 を表示

被引用文献:  8件中 1-8件 を表示

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各種コード

  • NII論文ID(NAID)
    10008523714
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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