Ahmet MİDİ, Özge AYABAKAN, Aydın SAV

Acquıred lymphangiectasis: A case report (major hallmarks in its differential diagnosis from lymphangioma circumscriptum)

Edinsel lenfanjektazi skar oluşumuna bağlı oluşan, yüzeyel lenfatiklerin dilatasyonu ile karakterize bir lezyondur. Sıklıkla yetişkinlerde radyoterapi ve cerrahi işlemimin geç komplikasyonu olarak ortaya çıkar ve histolojik olarak lenfangioma sirkumskriptumdan ayrılması zordur. Hastalarda genellikle radyoterapi uygulanan ya da uygulanmayan cerrahi işlemden yıllar sonra kronik lenfödematöz bölgede çok sayıda şeffaf veziküller oluşur. Biz cerrahi işlemden 17 yıl sonra oluşan bir edinsel lenfanjektazi olgusu sunmaktayız. Lezyonlar sol subaksiller bölge yerleşimliydi. Olgumuz literatürde operasyon sonrası bu kadar geç evrede oluşan ilk yayın olma özelliği taşımaktadır.

Edinsel lenfanjektazi: Olgu sunumu (lenfanjioma sirkumskriptumdan ayırıcı tanısında belirleyici özellikler)

Acquired lymphangiectasis is a superficial lymphatic dilatation caused by a wide range of scarring processes. Histologically indistinguishable from lymphangioma circumscriptum and commonly occurs in adults as a late sequel of surgery and radiation therapy. Patients usually present with numerous translucent vesicles in a chronic lymph edematous area several years after surgery with or without radiation therapy. We report a case of acquired lymphangiectasis, happened 17 years after the surgical intervention. Lesions were located the left subaxillary region. This is the first case that is reported so late in the literature after the surgery.

PDF

___

1) Levers’s histopathology of the skin. Ninth edition.Calonje E, Jones EW, 2005-Philadelphia;1047.
2) Ambrojo P, Cogolluda EF, Aguilar A, Sanchez Yus E, Sanchez de Paz F. Cutaneous lymphangiectases after therapy for carcinoma of the cervix a case with unusual clinical and histological features. Clin Exp Dermatol. 1990; 15:57-9.
3) Celis, AV, Gaughf CN, Sangueza, OP, Gourdin, FW. Acquired lymphangiectasis. South Med J. 1999; 92:69-72.
4) Kaya TI, Kokturk A, Polat A, Tursen U, Ikizoglu G. A case of cutaneous lymphangiectasis secondary to breast cancer treatment. Int J Dermatol. 2001; 40:760-1.
5) Giannelli V, Rockley, PF. Acquired lymphangiectasis following mastectomy and radiation therapy--report of a case and review of the literature. Cutis. 1996; 58:276-8.
6) Mallett, RB, Curley, GK, Mortimer, PS. Acquired lymphangioma: report of four cases and a discussion of the pathogenesis. Br J Dermatol. 1992; 126:380-2.
7) Tuffanelli DL. Letter: Lymphangiectasis due to scleroderma. Arch Dermatol. 1975; 111:1216.
8) Mortimer PS, Simmonds RH, Rezvani M, Robbins ME, Ryan TJ, Hopewell JW. Time-related changes in lymphatic clearance in pig skin after a single dose of 18 Gy of X rays. Br J Radiol. 1991; 64:1140-6.
9) Weingold DH, White PF, Burton CS. Treatment of lymphangioma circumscriptum with tunable dye laser. Cutis. 1990; 45:365-6.
10) Eliezri YD, Sklar JA. Lymphangioma circumscriptum: review and evaluation of carbon dioxide laser vaporization. J Dermatol Surg Oncol. 1988; 14:357-64.
11) Bailin PL, Kantor GR, Wheeland RG. Carbon dioxide laser vaporization of lymphangioma circumscriptum. J Am Acad Dermatol. 1986; 14:257-62.
12) Tasdelen I, Gokgoz S, Paksoy E, Yerci O, Cetintas SK, Demiray M, Samsa V. Acquired lymphangiectasis after breast conservation treatment for breast cancer: report of a case. Dermatol Online J. 2004; 10:9-13.
13) Peachey RDG, Lim CC, Whimster JW. Lymphangioma of the skin: a review of 65 cases. Br J Dermatol 1970; 83:519-27.
14) Ziv R, Schewach-Miller M, Trau U. Lymphangiectasia. A complication of thoracotomy for bronchial carcinoid. Int J Dermatol. 1988; 27:123-26.
15) Di Leonardo M, Jacoby RA. Acquired cutaneous Lymphangiectasia secondary to scarring from scrofuloderma. J Am Acad Dermatol. 1986; 14:688-90.
16) Garcia-Doval I, de la Torre C, Losada A, Ocampo C, Rodriguez T, Cruces MJ. Acquired cutaneous lymphangiectasia in a patient with cirrhotic ascites. J Eur Acad Dermatol Venereol. 1999; 13:109-12.
17) Jappe U, Zimmermann T, Kahle B, Peyzoldt D. Lymphangioma circumscriptum of the vulva following surgical and radiological therapy of cervical cancer. Sex Transm Dis. 2002; 29:533-5
18) Abu-Hamad A, Provencher D, Ganjei P, Penalver M. Lymphangioma circumscriptum of the vulva: case report and review of the literature. Obstet Gynecol. 1989; 73:496-9. Review
19) Huilgol SC, Neill S, Barlow RJ. CO(2) laser therapy of vulval lymphangiectasia and lymphangioma circumscriptum. Dermatol Surg. 2002; 28(7):575-7.