The Possible Role of Color Doppler and Pulse Wave Doppler Ultrasound in the Diagnosis of Cutaneous Lymphangioma Circumscriptum
The Possible Role of Color Doppler and Pulse Wave Doppler Ultrasound in the Diagnosis of Cutaneous Lymphangioma Circumscriptum
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DOI：
10.1097/scs.0000000000005926
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发表时间：
2020-01-01
影响因子：
0.9
通讯作者：
Cui, Li-Gang
中科院分区：
文献类型：
--
作者：
Sun, Yang;Su, Jing;Cui, Li-Gang
皮肤周围淋巴管瘤（CLC）是一种罕见的先天性淋巴管畸形。其皮肤镜特征已被报道，然而，如果血液渗入腔隙，则粉红色调会覆盖腔隙结构，使皮肤镜特征难以区分。此外，皮肤镜检查无法在术前评估病变的皮下范围。采用高频换能器的高频阵列换能器超声检查在评估皮肤病变方面具有出色的分辨率，并且不受血液浸润的影响。在这里，作者报告了使用超声（彩色多普勒和脉冲波多普勒）来诊断和治疗 CLC。 一名 18 岁男性在 10 年前就诊，臀部出现无症状的 0.5 x 0.7 厘米簇的暗红色水疱性病变。病变的大小和数量最近有所增加。存在相关的厚皮病。病变在灰度超声上呈高回声且轮廓清晰，在彩色多普勒超声上呈血管丰富。整个真皮，特别是真皮乳头层均发现淋巴管簇状囊肿。淋巴管向下延伸至真皮网状层及皮下组织浅层。病理结果显示淋巴管瘤侵犯皮下组织。扁平内皮细胞的 D2-40 部分呈阳性，D2-40 是淋巴管内皮细胞的标志物。超声波能够勾画出病变的边缘。术前使用彩色多普勒和脉冲波多普勒诊断 CLC 可以减少不必要的术前和术后重复活检。
Cutaneous lymphangioma circumscriptum (CLC) is an uncommon congenital lymphatic malformation. Its dermoscopic features have been reported, however, if blood has infiltrated the lacunas, a pink hue overwhelms the lacunar structures, rendering dermoscopic features indistinguishable. In addition, dermoscopy cannot assess the subcutaneous extent of the lesion before surgery. The high-frequency array transducer Sonography with a high-frequency transducer is excellent in its resolution to evaluate skin lesions and is unaffected by infiltration of blood. Here, the authors report the use of ultrasound (color Doppler and pulse wave Doppler) for the diagnosis and management of CLC.An 18-year-old man presented 10 years previously with an asymptomatic 0.5 x 0.7 cm cluster of dark reddish vesicular lesions on his buttock. The lesions had recently increased in size and number. There was associated pachyderma. The lesions were hyperechoic and well defined on grayscale ultrasound and hypervascular on color Doppler ultrasound. Cluster cystics of lymphatic spaces were found throughout the whole dermis, especially in the papillary dermis. The lymphatic channels extended downwards to the reticular dermis and the superficial layer of the subcutaneous tissue. The pathological findings revealed lymphangiomas invading the subcutaneous tissue. The flat endothelial cells were partly positive for D2-40, which is a marker of lymphatic endothelial cells. Ultrasound was able to delineate the margins of the lesions. Diagnosis of CLC using preoperative color Doppler and pulse wave Doppler could reduce unnecessary repeated pre- and postoperative biopsies.