Zusammenfassung
Lymphangiome sind seltene Läsionen der lymphatischen Kanäle, die oft bereits bei der Geburt bestehen und zumeist (in 90% der Fälle) vor dem 2. Lebensjahr diagnostiziert werden. Nur wenige Fälle eines Auftretens im Erwachsenenalter wurden bisher in der Literatur beschrieben. Die Therapie der Wahl ist die komplette operative Entfernung. Manchmal ist dies allerdings nicht möglich, da der Tumor dazu tendiert, sich entlang lebensnotwendiger Strukturen auszubreiten. Wir beschreiben die klinischen und pathologischen Eigenschaften von zystischen Lymphangiomen bei 3 Erwachsenen: Die Tumoren traten alle im lateralen Halsbereich auf. Es wurden eine klinische Untersuchung, Ultraschall, MR sowie FNAC durchgeführt. Wir diskutieren die Schwierigkeiten bei der korrekten Diagnose dieser seltenen Läsion, die in vielen Fällen erst bei der histopathologischen Untersuchung möglich ist Die therapeutischen Optionen werden ebenfalls kurz beschrieben. Unsere Fälle zeigen, dass bei der Differentialdiagnose lateraler Halstumoren zystische Lymphangiome berücksichtigt werden sollten. Außerdem betonen sie die Notwendigkeit für eine adäquate Bildgebung und Zytologie, um die präoperative Verdachtsdiagnose zu erhärten.
Summary
Lymphangiomas are uncommon lesions of lymphatic channels that are often present at birth and diagnosed mostly (90%) before the age of two years. Lymphangiomas occur exceedingly rarely in adults and few cases are described in the literature. The treatment of choice is complete surgical removal; however, the tumor tends to spread along vital structures therefore sometimes inductive complete surgical removal is impossible. We describe the clinical and pathological features of cystic lymphangioma diagnosed in three adults with lateral neck mass. Clinical examination, ultrasonography, MRI and fine-needle aspiration cytology were performed. We discuss the diagnostic difficulties of this uncommon lesion where in many cases the correct diagnosis is reached only after histopathological investigation of the surgical specimen. Therapeutic options are briefly described. Our cases suggest the need to consider cystic lymphangioma in the differential diagnosis of lateral neck masses in adults, together with adequate imaging and cytological studies to corroborate the preoperative diagnosis.
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Kraus, J., Plzák, J., Bruschini, R. et al. Cystic lymphangioma of the neck in adults: a report of three cases. Wien Klin Wochenschr 120, 242–245 (2008). https://doi.org/10.1007/s00508-008-0950-4
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DOI: https://doi.org/10.1007/s00508-008-0950-4