诊断陷阱:软组织淋巴瘤模仿静脉畸形的浅表软组织淋巴瘤

Victoire Roblot, Valérie Bousson, Annouk Bisdorff
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引用次数: 0

摘要

在本病例报告中,我们报告了三例到血管异常参考中心就诊的慢流血管异常患者。我们的目的是强调,临床和放射学数据之间的差异应提示鉴别诊断,并考虑进行经皮活检。在我们的 3 例患者中,活检提供了软组织淋巴瘤的诊断。为避免漏诊,患者的淋巴瘤既往病史和临床触诊发现的不可压迫的硬性病变是不可忽视的信号。在磁共振成像中,病变的形状和轮廓,尤其是棘突的存在,似乎是考虑淋巴瘤的有趣特征(常见的静脉畸形则无此征象)。因此,要准确诊断血管畸形,必须结合既往病史、临床和影像学数据(超声波和核磁共振成像)。
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Diagnostic Pitfalls: Soft Tissue Lymphoma: Superficial Soft Tissue Lymphoma Mimicking a Venous Malformation
In this case report, 3 patients addressed to our vascular anomalies reference center to manage a slow-flow vascular anomaly were reported. Our objective is to highlight that a discrepancy between clinical and radiological data should suggest a differential diagnosis and a percutaneous biopsy be considered. In our 3 patients, the biopsy provided a diagnosis of soft tissue lymphoma. Some red flags should not be overlooked to avoid missing this diagnosis, patient's past medical history of lymphoma and clinical palpation of a nondepressible hard lesion. On magnetic resonance imaging, the lesion shape and contours particularly the presence of spicules appear to be interesting features to consider lymphoma (this sign is absent in common venous malformation). Therefore, the triad past medical history and clinical and imaging data (ultrasound and MRI) are mandatory for an accurate diagnosis of vascular malformations.
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