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Vol. 40. Issue 12.
Pages 599-601 (December 2004)
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Vol. 40. Issue 12.
Pages 599-601 (December 2004)
Case Reports
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Diffuse Thoracic Lymphangiomatosis: Diagnosis and Treatment
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3073
E.J. Bermejo Casero*, R. Mongil Poce, R. Arrabal Sánchez, A. Fernández de Rota Avecilla, A. Benítez Doménech, J.L. Fernández Bermúdez
Servicio de Cirugía Torácica, Hospital Regional Universitario Carlos Haya, Málaga, Spain
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Histologically, lymphangiomatosis is a rare type of benign neoplasm caused by abnormal development and proliferation of the lymphatic system. Thoracic lymphangiomatosis can present in a localized (lymphangioma) or diffuse form (lymphangiomatosis). In most cases the disease progresses to serious morbidity or even death.

The treatment of choice for localized disease is usually surgery or, less frequently, local injection of sclerosing agents (streptococcus antigen OK-432). However, in diffuse forms there is a gelatinous infiltrate without defined limits. In these cases the main treatment option is radiotherapy.

We report 2 cases of diffuse thoracic lymphangiomatosis with pulmonary infiltrate. In both cases radiotherapy in appropriate doses successfully eliminated pulmonary infiltrates, pleural effusion, dyspnea, and general discomfort. Surgery was needed to resolve complications of the disease and for diagnosis.

Key Words:
Thoracic lymphangiomatosis
Thoracic lymphangioma
Bronchovascular infiltrates

La linfangiomatosis constituye una rara clase de tumora-ción benigna, desde el punto de vista histológico, resultado de un anormal desarrollo y proliferación del sistema linfáti-co. La afectación torácica puede presentarse localizada (linfangioma) o difusa (linfangiomatosis). En la mayoría de los casos el curso evolutivo de la enfermedad es progresivo con aparición de clara morbilidad e incluso mortalidad.

En las formas localizadas la cirugía, principalmente, o la instilación local de sustancias esclerosantes (antígeno estrep-tocócico OK-432) son el tratamiento elegido. Ahora bien, en las formas difusas existe un material gelatinoso, infiltrante, sin límites definidos. Aquí la radioterapia constituye la principal opción terapéutica.

Se presentan 2 casos de linfangiomatosis torácica difusa con infiltración pulmonar. Se comprueba que la radioterapia a dosis adecuadas consigue la desaparición de los infil-trados pulmonares y del derrame pleural, así como de la disnea y mal estado general. La cirugía es necesaria en la re-solución de las complicaciones paralelas a la enfermedad y como técnica diagnóstica.

Palabras clave:
Linfangiomatosis torácica
Linfangioma toráci-co
Infiltrados broncovasculares
Full text is only aviable in PDF
REFERENCES
[1]
JL Faul, GJ Berry, TV Colby, SJ Ruoss, MB Walter, GD Rosen, et al.
Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis and lymphatic dysplasia syndrome.
Am J Respir Crit Care Med, 161 (2000), pp. 1037-1046
[2]
SJ Swensen, TE Hartman, JR Mayo, TV Colby, HD Tazelaar, NL Muller.
Diffuse pulmonary lymphangiomatosis: CT findings.
J Comput Assist Tomgr, 19 (1995), pp. 348-352
[3]
JM Díez Piña, J Ruiz Zafra, C Pagés Navarrete.
Linfangioma quístico mediastínico.
Arch Bronconeumol, 36 (2000), pp. 165
[4]
B Banieghbal, MRQ Davies.
Guidelines for the successful treatment of lymphangioma with OK-432.
Eur J Pediatr Surg, 13 (2003), pp. 103-107
[5]
AY Rostom.
Treatment of thoracic lymphangiomatosis.
Arch Dis Child, 83 (2000), pp. 138-139
Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
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