Lymphangiomatosis involving the pulmonary and extrapulmonary lymph nodes and surrounding soft tissue: A rare case report.
|Abstract||Diffuse pulmonary lymphangiomatosis (DPL) mainly affects the lung and pleura. There are very few pathological reports of lung damage accompanied by diffuse involvement of the extrapulmonary lymph nodes and surrounding soft tissue. The clinicopathological significance of coexistence of pulmonary and extrapulmonary lesions is unknown.|
Thoracic lymphangiomatosis with massive chylothorax after a tumor biopsy and with disseminated intravenous coagulation--lymphoscintigraphy, an alternative minimally invasive imaging technique: report of a case.
|Publication Year Start||2017-01-01|
PMID- 29245295 OWN - NLM STAT- MEDLINE DCOM- 20171226 LR - 20171226 IS - 1536-5964 (Electronic) IS - 0025-7974 (Linking) VI - 96 IP - 49 DP - 2017 Dec TI - Lymphangiomatosis involving the pulmonary and extrapulmonary lymph nodes and surrounding soft tissue: A rare case report. PG - e9032 LID - 10.1097/MD.0000000000009032 [doi] AB - BACKGROUND: Diffuse pulmonary lymphangiomatosis (DPL) mainly affects the lung and pleura. There are very few pathological reports of lung damage accompanied by diffuse involvement of the extrapulmonary lymph nodes and surrounding soft tissue. The clinicopathological significance of coexistence of pulmonary and extrapulmonary lesions is unknown. METHODS: Here, we report a 16-year-old male patient. The pathological specimens of the supraclavicular lymph node and soft tissue together with the lung biopsy were analyzed by pathological observation and immunohistochemical staining. Literatures were reviewed and clinical and imaging findings were discussed. RESULTS: The patient presented with coughing and expectoration for 1 year and intermittent hemoptysis for 4 months. Ultrasound revealed swollen lymph nodes in bilateral neck, left armpit, and pubic symphysis. Chest CT scan showed diffuse grid and linear shadows, bilateral pleural thickening, and nodule formation. Multiple enlarged lymph nodes were mainly investigated in bilateral hilar, mediastinal, para-aortic, lesser curvature, and retroperitoneal. Supraclavicular lymph node biopsy confirmed the lymphatic hyperplasia and expansion in the capsule and surrounding soft tissue. The thoracoscopic examination found bloody chylothorax on the left chest. And lung biopsy showed the lymphatic vessel hyperplasia and expansion on the pleura and adjacent lung tissue. Immunohistochemical stains showed that the lymphatic endothelial cells were positive for D2-40 and CD31. Lymphangiomatosis involving the pulmonary and extrapulmonary lymph nodes and surrounding soft tissue was diagnosed based on the aforementioned histological findings. CONCLUSION: Lymphangiomatosis of superficial lymph node mainly involves the capsule of lymph nodes and its surrounding soft tissue. The information obtained from the lymph node biopsy can prompt and assist the diagnosis of DPL. FAU - Fang, Xuhua AU - Fang X AD - aDepartment of ENT, Children's Medical Center, Shanghai Jiao Tong University, ShanghaibDepartment of Pathology, Shanghai Tongji Hospital, Tongji Hospital Affiliated to Tongji University, ShanghaicDepartment of Pathology, Chongqing Medical University, ChongqingdDepartment of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. FAU - Huang, Ziling AU - Huang Z FAU - Zeng, Yu AU - Zeng Y FAU - Zhu, Xuyou AU - Zhu X FAU - Wang, Siqi AU - Wang S FAU - Yu, Xiaoting AU - Yu X FAU - Li, Xian AU - Li X FAU - Wu, Chunyan AU - Wu C FAU - Yi, Xianghua AU - Yi X LA - eng PT - Case Reports PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - Lymphangiectasia, pulmonary, congenital SB - AIM SB - IM MH - Adolescent MH - Biopsy MH - Humans MH - Lung Diseases/*congenital/pathology MH - Lymph Nodes/*pathology MH - Lymphangiectasis/*congenital/pathology MH - Male MH - Neck/pathology MH - Thorax/pathology PMC - PMC5728910 EDAT- 2017/12/17 06:00 MHDA- 2017/12/27 06:00 CRDT- 2017/12/17 06:00 PHST- 2017/12/17 06:00 [entrez] PHST- 2017/12/17 06:00 [pubmed] PHST- 2017/12/27 06:00 [medline] AID - 10.1097/MD.0000000000009032 [doi] AID - 00005792-201712080-00084 [pii] PST - ppublish SO - Medicine (Baltimore). 2017 Dec;96(49):e9032. doi: 10.1097/MD.0000000000009032.