lymphangioma of bone
Introduction
Introduction to bone lymphangioma Lymphangioma is a benign tumor composed of neoplastic lymphatic vessels, which occurs mostly in soft tissues. It is extremely rare in the bone. It accounts for 0.03% of primary bone tumors and 0.06% of benign bone tumors. Lymphatic vessels are present in the periosteum. When there are lymphangioma-like cysts near the bone marrow, abnormally expanding lymphatic vessels that communicate with the cysts can be seen in the bone. basic knowledge Sickness ratio: 0.0001% Susceptible people: more common in young people aged 10 to 20 Mode of infection: non-infectious Complications: fractures chylothorax
Cause
Cause of bone lymphangioma
(1) Causes of the disease
It is a benign tumor composed of new lymphatic vessels, and the specific cause is unclear.
(two) pathogenesis
1. Visual observation
The tumor is invasively growing, without a complete capsule, and the cut surface is spongy. It is a dilated vascular lumen formed by endothelial cells. The lumen is filled with a pale yellow liquid, and the dilated lumen produces compression atrophy of the surrounding bone tissue.
2. See you under the microscope
The tumor consists of a dilated lymphatic vessel formed by many endothelial cells. The inside of the tube is a lymphatic fluid with a small amount of lymphocytes.
Prevention
Bone lymphangioma prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Bone lymphangioma complications Complications, fracture, chylothorax
When the bone destruction is serious, it can be combined with a rational fracture, and it can also be combined with chylothorax.
Symptom
Symptoms of bone lymphangioma Common symptoms Acute pain edema muscle atrophy fibrous structure poor subcutaneous fat increase
The disease is often multiple, can also be single, can occur at any age, more common in young people aged 10 to 20 years, there is no significant difference in gender, lesions easily occur in long bones, skull, spine, pelvis, jaw bone, hand and foot bones Involved.
Symptoms and signs: a small number of patients lack of symptoms, most patients have slow onset, often have mild pain or severe pain, the affected part is tender and painful, and the activity is limited. The lesion puncture can extract light yellow or yellow-brown transparent liquid. Pathogenesis often occurs when bone destruction is serious. Sexual fracture, loss of limb function, occurs in the limbs, but also due to lymphedema, limb hypertrophy, diffuse edema, increased subcutaneous fat and muscle atrophy, local swelling, no redness of the skin and venous engorgement, occurring in the spine There may be symptoms of spinal nerve compression, bone and soft tissue are often involved at the same time, when other organs also have multiple lesions, there are often chylothorax.
Patients of any age, if the onset is slow, long course, no symptoms or slight pain, swelling, swelling, tenderness, especially limb thickening, diffuse edema, X-ray film found lesions located in the backbone or metaphysis or flat The bone is osteolytic destruction, the cortical swelling is thin, the medullary cavity is destroyed by polycystic bone, and the boundary is clear. After identification with bone hemangioma, giant cell tumor of bone, polycystic fibrous dysplasia, etc., bone lymph should be considered clinically. Diagnosis of tube tumor, if the cystic cavity puncture draws a pale yellow liquid, the laboratory examination is lymph, then the bone cyst can be excluded, and the diagnosis is bone lymphangioma. If the tumor is seen, the tumor is formed by many endothelial cells. The composition of the tube, the inside of the tube is lymph, can be diagnosed as a bone lymphangioma.
Examine
Examination of bone lymphangioma
X-ray showed that the lesion was located in the trunk or metaphysis or flat bone, which showed different degrees of osteolytic destruction. The cortex expanded and thinned, even disappeared or only loosely left, the cortical margin was irregular and irregular, and the cancellous bone marrow and bone marrow cavity It has multiple cystic bone destruction, and the edge is clear. There are more reticular bone-like septa in the destruction zone. When the lesion is extensive, the backbone can be slightly curved or thick and thin. It occurs in the periosteum, and early compression depression can also cause Extensive destruction of the cortical bone, the rupture is silkworm-like, occurs in long bones, may have lamellar or radial periosteal reaction, local soft tissue mass may appear after the cortical bone is worn, the limbs are thickened, and the subcutaneous fat is thickened.
Lymphatic angiography showed that the lymphatic drainage time of the affected limb was prolonged, partial or complete lymphatic obstruction was observed, collateral circulation occurred, and angiography was performed for 24 to 48 hours. The contrast agent was filled in the intracapsular sac, and the contrast agent stayed in the intraosseous lesion. It can reach several months and can find abnormally enlarged lymphatic vessels.
Diagnosis
Diagnosis and diagnosis of bone lymphangioma
Lymphatic angiography has a diagnostic significance for the disease. If the angiography shows lymphatic obstruction and the contrast agent is filled and stayed in the intracapsular cavity, the lymphangioma can be diagnosed.
Attention should be paid to the identification of bone hemangioma, giant cell tumor of bone, and polycystic fibrous dysplasia.
