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1.
Tech Vasc Interv Radiol ; 22(4): 100632, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864531

RESUMO

Complex lymphatic anomalies include a variety of disorders with overlapping clinical, histological and imaging features. The often-confusing nomenclature used for lymphatic anomalies limits timely diagnosis and treatment. The updated 2018 classification of the International Society for the Study of Vascular Anomalies divides lymphatic anomalies into several subsets.1 Newer imaging techniques including intranodal and magnetic resonance lymphangiography have improved our understanding of anatomy and function of the lymphatic system. Advances in medical, interventional, and surgical treatments have opened a realm of new therapeutic options for patients with complex lymphatic disorders.


Assuntos
Anormalidades Linfáticas/terapia , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Linfografia , Imagem por Ressonância Magnética , Osteólise Essencial/diagnóstico por imagem , Osteólise Essencial/fisiopatologia , Osteólise Essencial/terapia , Valor Preditivo dos Testes , Resultado do Tratamento
3.
Artigo em Chinês | MEDLINE | ID: mdl-31262116

RESUMO

More than seventy percent of lymphatic malformations (LMs) occur in head and neck region. The management of head and neck LMs is challenging,especially for diffuse and infiltrative cases.It can cause deformity and death in severe patients. Surgical resection is the main method to treat LMs in the past and sclerotherapy has also greatly improved the treatment out come of LMs over the past 20 years. However, it is still hardly to achieve satisfactory prognosis for the patients with extensively infiltrative lesions, regardless of surgical resection or sclerotherapy. In the past five years, some scholars have made a preliminary exploration of new treatment methods, such as oral medicine, to diversify the treatment options of head and neck LMs. This article will review the general situation, biological properties, clinical characteristics, diagnostic methods, and current treatment strategies for LMs as well as trends in management of LMs.


Assuntos
Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/terapia , Cabeça , Humanos , Pescoço , Escleroterapia , Resultado do Tratamento
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(5): 303-308, 2019 May 09.
Artigo em Chinês | MEDLINE | ID: mdl-31091562

RESUMO

Objective: To explore the clinical classification of microcystic lymphatic malformations of tongue and observe the treatment of microcystic lymphatic malformations of tongue by retrospective analysis, in order to provide reference for clinical practice. Methods: From October 2005 to October 2015, the complete data of 220 cases of microcystic lymphatic malformations of tongue (115 males and 105 females) received and treated in Provincial Special Department of Vascular Anomalies, Linyi Tumor Hospital was analyzed retrospectively. The age ranged from 8 months to 52 years old, with a median age of 16 years old. All patients were followed up for 3 years, and according to their clinical manifestations, they were divided into three types: localized type of 23 cases, diffuse type of 161 cases, and megaloglossia type of 36 cases. Injection with pingyangmycin merely was performed on 58 cases, whereas merely surgery on 20 cases, injection with pingyangmycin combined with high frequency electrocoagulation on 55 cases, and surgery combined with injection with pingyangmycin on 87 cases. The therapeutic effect was evaluated according to the grade 4 standard. The χ(2) test was used for statistical analysis of count data. Rank sum test was used for statistical analysis of ranked data. Results: The percentage of surgery merely of localized type was 87.0% (20/23), significantly higher than that of other types of lesions [0% (0/197)] (χ(2)=178.060, P<0.001). The percentage of injection with pingyangmycin of diffuse type was 100% (161/161), significantly higher than that of other types of lesions [66.1% (39/59)] (χ(2)=60.034, P<0.001). The percentage of surgery combined with injection with pingyangmycin of megaloglossia type was 100% (36/36), significantly higher than that of other types of lesions [27.7% (51/184)] (χ(2)=65.800, P<0.001). After follow-ups for 3 to13 years, there were 0 cases of gradeⅠ, 11 cases of grade Ⅱ, 50 cases of grade Ⅲ, and 159 cases of grade Ⅳ. There were statistically significant differences in clinical efficacy among different clinical types (H=158.668, P<0.001). The percentage of level Ⅳ efficacy of localized type, diffuse type and megaloglossia type were 100% (23/23), 82.6% (133/161) and 8.3% (3/36) respectively. Local mucosa ulcer appeared in 45 cases and was cured through oral care and expectant treatment. Fever occurred in 28 cases and returned to normal within 24 h after expectant treatment. The lingual frenum was shortened in 16 cases. There were 12 cases with mild tongue swelling, 6 cases with influence on eating but without influence on breathing, and recovered spontaneously one week later. Conclusions: The choice of different treatment methods of microcystic lymphatic malformations of tongue should be made according their clinical classification. The only surgical resection is recommended for localized protrude lesions. Injection with pingyangmycin in high tension combined with surgical resection or high frequency electrocoagulation is effective for diffuse lesions. Surgical resection combined with injection with pingyangmycin is suitable for the patients with megaloglossia type.


Assuntos
Cistos , Anormalidades Linfáticas , Doenças da Língua , Adolescente , Bleomicina , Feminino , Humanos , Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/terapia , Masculino , Estudos Retrospectivos , Língua , Doenças da Língua/diagnóstico , Doenças da Língua/terapia , Resultado do Tratamento
7.
Int J Obstet Anesth ; 38: 142-145, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30243809

RESUMO

High-dose volatile anesthesia is the most common method of achieving uterine relaxation for Ex Utero Intrapartum Therapy (EXIT) procedures. Other methods employ nitroglycerin for additional uterine relaxation with or without remifentanil for additional fetal analgesia. We report a combination approach including one minimum alveolar concentration of volatile anesthetic plus nitroglycerin and remifentanil infusions, to provide timely uterine relaxation under general anesthesia for both mother and fetus, during two EXIT procedures.


Assuntos
Anestesia Geral/métodos , Anestesia Obstétrica/métodos , Anormalidades Craniofaciais/diagnóstico por imagem , Anormalidades Craniofaciais/terapia , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/terapia , Útero/efeitos dos fármacos , Adulto , Analgésicos Opioides/administração & dosagem , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Masculino , Nitroglicerina/administração & dosagem , Gravidez , Remifentanil/administração & dosagem , Ultrassonografia Pré-Natal/métodos , Vasodilatadores/administração & dosagem
8.
J Surg Res ; 233: 256-261, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30502256

RESUMO

BACKGROUND: Lymphatic malformations (LMs) are congenital and arise from errors in vascular embryogenesis. LMs are categorized by cyst size as microcystic, macrocystic, or combined. Abdominal LMs are rare. Surgical resection of abdominal LMs has been the mainstay of therapy, but recurrence and morbidity are high. We sought to determine the effectiveness of sclerotherapy treatment for abdominal LM. METHODS: A single-center, retrospective review from 2014 to 2018 was conducted evaluating pediatric patients with abdominal LM. RESULTS: Ten patients were included, n = 9 had macrocystic LM and one patient had combined disease. The average age at first treatment was 6.8 y. The most common presenting symptoms were abdominal distention, pain, infection, and anemia. Preprocedural imaging was performed for all patients; median pretreatment volume was 1572.9 cm3 (range, 67.2-13,226.4). LMs were accessed using ultrasound guidance and injected with opacified doxycycline. Patients received a mean of 7.1 sclerotherapy injections. Complications included intraperitoneal doxycycline extravasation (n = 1), managed conservatively, and LM infection (n = 1), treated with intravenous antibiotics and drainage. One patient went on to surgical resection due to inability gain stable intracystic access; follow-up ultrasonography showed no recurrence. Postprocedural imaging was available in n = 8. Volume decreased by 96.7% after sclerotherapy. The median remaining volume was 0 cm3 (range, 0-599.7) (P = 0.016). Postsclerotherapy magnetic resonance imaging was obtained in n = 6, with complete resolution in 83.3%. All patients had resolution of presenting symptoms. Follow-up duration was 12.3 mo. CONCLUSIONS: Initial results demonstrate that sclerotherapy is an effective and durable treatment for symptom resolution and volume reduction of abdominal LM.


Assuntos
Doxiciclina/administração & dosagem , Anormalidades Linfáticas/terapia , Escleroterapia/métodos , Prevenção Secundária/métodos , Cavidade Abdominal/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/etnologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Anormalidades Linfáticas/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Recidiva , Estudos Retrospectivos , Escleroterapia/efeitos adversos , Resultado do Tratamento , Ultrassonografia de Intervenção
9.
Orbit ; 38(1): 30-36, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29902086

RESUMO

PURPOSE: Bleomycin sclerotherapy has been shown to be a viable treatment for lymphatic malformations. However, its use for these lesions confined to the orbit is becoming increasingly documented in the literature. In this study, we summarize the clinical manifestations and outcomes observed following percutaneous bleomycin sclerotherapy for orbital lymphatic malformation. METHODS: A 5-year retrospective chart review of patients with clinical, radiographic, and/or biopsy-confirmed diagnoses of orbital lymphatic malformation that received bleomycin sclerotherapy was conducted at the Emory Hospital and Clinics. Data examined included patient demographics, patient history and symptoms, clinical findings, radiographic findings, route of bleomycin delivery, and outcome. RESULTS: Of the 10 patients who met inclusion criteria, the median age of treatment was 7 years. The most common presenting symptoms included vision change and proptosis. Nine of 10 patients demonstrated macrocysts (>1 cm) on imaging. Seven of 10 patients had histories of prior interventions including resections, cyst drainage, and debulking. Because 2 of these 10 patients were lost to follow-up, 8 patients remained for post-procedural evaluation. Four of these eight showed improvement of visual acuity after post-bleomycin sclerotherapy. In seven of eight patients, extraocular motility either improved or remained stable. Pretreatment and posttreatment exophthalmometer measurements obtained in four patients revealed an average improvement in proptosis of 65% from their average pretreatment measurements. CONCLUSIONS: Our findings suggest that percutaneous bleomycin sclerotherapy is a viable option for treatment of orbital lymphatic malformations, with potentially greater benefit to those with macrocystic features.


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Bleomicina/uso terapêutico , Anormalidades Linfáticas/terapia , Doenças Orbitárias/terapia , Escleroterapia/métodos , Administração Cutânea , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Masculino , Doenças Orbitárias/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
10.
Cardiovasc Intervent Radiol ; 42(3): 433-440, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30488306

RESUMO

PURPOSE: To evaluate the effectiveness and safety of image-guided percutaneous sclerotherapy using bleomycin for macrocystic and bevacizumab (Avastin™) for microcystic orbital lymphatic malformations in children. MATERIALS AND METHODS: Between October 2015 and July 2018, we prospectively evaluated 10 pediatric patients who presented clinically and radiologically with lymphatic malformations and were treated with percutaneous sclerotherapy. Patients with venous malformations were excluded. Eight females and two males with ages ranging from 3 to 17 years (mean: 8.8, SD: 4.9) were included. Guided with ultrasound and fluoroscopy, macrocysts were treated with bleomycin instillation. For microcystic components in three patients, bevacizumab was injected intralesional. All patients underwent ultrasound and non-contrast MRI to evaluate response to treatment after 6 weeks. RESULTS: The malformations were macrocystic in seven patients and complex (macro/microcystic) in three. Twenty sclerotherapy sessions were performed, (range: 1-3 sessions, mean: 2, SD: 0.8). Clinically, there was a significant reduction in the proptosis after treatment (P = 0.007) and dystopia (P = 0.018). The local radiological response showed a reduction in the maximum lesions diameters and volumes after treatment (P = 0.005 and 0.005, respectively). Two of the three patients treated with bevacizumab showed a reduction in the lesions volumes by 90.4% and 63.4%, respectively, whereas one patient did not show volume reduction. Transient periorbital edema and ecchymosis occurred following the procedure with no major complications encountered. Follow-up ranged from 9-33 months, mean: 20.3, SD: 7.4. CONCLUSION: Bleomycin sclerotherapy is a safe and effective treatment for orbital macrocystic lymphatic malformations. Further use of bevacizumab for microcystic lesions in a larger series is required to outline its efficacy and safety.


Assuntos
Bevacizumab/uso terapêutico , Bleomicina/uso terapêutico , Anormalidades Linfáticas/terapia , Doenças Orbitárias/terapia , Escleroterapia/métodos , Ultrassonografia de Intervenção/métodos , Adolescente , Antibióticos Antineoplásicos/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Criança , Pré-Escolar , Feminino , Fluoroscopia , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Vasos Linfáticos/diagnóstico por imagem , Masculino , Doenças Orbitárias/diagnóstico por imagem , Estudos Prospectivos , Radiografia Intervencionista/métodos , Resultado do Tratamento
11.
Biomed Res Int ; 2018: 3878960, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30498754

RESUMO

Management of LMs still remains a challenge especially for those suffering from complications such as acute airway compression. In this study, we retrospectively evaluated the efficacy and safety of percutaneous lauromacrogol foam sclerotherapy for the patients with acute airway compression caused by lymphatic malformations (LMs) in infants. Five cases of infants with acute airway compression caused by LMs were treated with lauromacrogol foam sclerotherapy in the radiology department from February 2013 to August 2015 at Wuhan Medical and Healthcare Center for Women and Children, China. By CT examination and the DSA imaging, LMs were diagnosed and progressed cervical and sublingual LMs combined with hemorrhages were observed and suppression of the trachea was noticed as well, resulting in the difficulty with breathing and feeding. For all the patients, we extracted most cyst liquid from the LMs to reduce the surface tension and alleviate the respiratory pressure symptoms under the guidance of ultrasound. Subsequently, the lauromacrogol foam was injected percutaneously into the cyst of LMs. The dose of the agent was determined according to the size of the LMs, which was 3-8 ml in our study. After treatment, autonomous respiration and independent eating were observed. When the procedures were completed after 16 cycles, the cyst cavity became atrophic and then nearly vanished. During the follow-up period (a minimum of three months and a maximum of two years), 4 patients were clinically proved to be cured and one patient was significantly improved. There was no recurrence, serious complications, or adverse reactions. Our study demonstrated that percutaneous sclerotherapy combined with lauromacrogol foam is a safe, effective therapy for acute airway compression caused by LMs, especially giving a good cosmetic result.


Assuntos
Pulmão/patologia , Anormalidades Linfáticas/terapia , Polidocanol/uso terapêutico , Escleroterapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
14.
Rofo ; 190(9): 825-835, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29874693

RESUMO

BACKGROUND: Vascular anomalies are a diagnostic and therapeutic challenge. They require dedicated interdisciplinary management. Optimal patient care relies on integral medical evaluation and a classification system established by experts in the field, to provide a better understanding of these complex vascular entities. METHOD: A dedicated classification system according to the International Society for the Study of Vascular Anomalies (ISSVA) and the German Interdisciplinary Society of Vascular Anomalies (DiGGefA) is presented. The vast spectrum of diagnostic modalities, ranging from ultrasound with color Doppler, conventional X-ray, CT with 4 D imaging and MRI as well as catheter angiography for appropriate assessment is discussed. RESULTS: Congenital vascular anomalies are comprised of vascular tumors, based on endothelial cell proliferation and vascular malformations with underlying mesenchymal and angiogenetic disorder. Vascular tumors tend to regress with patient's age, vascular malformations increase in size and are subdivided into capillary, venous, lymphatic, arterio-venous and combined malformations, depending on their dominant vasculature. According to their appearance, venous malformations are the most common representative of vascular anomalies (70 %), followed by lymphatic malformations (12 %), arterio-venous malformations (8 %), combined malformation syndromes (6 %) and capillary malformations (4 %). CONCLUSION: The aim is to provide an overview of the current classification system and diagnostic characterization of vascular anomalies in order to facilitate interdisciplinary management of vascular anomalies. KEY POINTS: · Vascular anomalies are comprised of vascular tumors and vascular malformations, both considered to be rare diseases.. · Appropriate treatment depends on correct classification and diagnosis of vascular anomalies, which is based on established national and international classification systems, recommendations and guidelines.. · In the classification, diagnosis and treatment of congenital vascular anomalies, radiology plays an integral part in patient management.. CITATION FORMAT: · Sadick M, Müller-Wille R, Wildgruber M et al. Vascular Anomalies (Part I): Classification and Diagnostics of Vascular Anomalies. Fortschr Röntgenstr 2018; 190: 825 - 835.


Assuntos
Doenças Raras , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Anormalidades Múltiplas/classificação , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/terapia , Adulto , Malformações Arteriovenosas/classificação , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Criança , Diagnóstico Diferencial , Diagnóstico por Imagem/métodos , Humanos , Anormalidades Linfáticas/classificação , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/terapia , Síndrome , Malformações Vasculares/terapia , Neoplasias Vasculares/classificação , Neoplasias Vasculares/terapia
15.
Cardiovasc Intervent Radiol ; 41(10): 1494-1504, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29948003

RESUMO

PURPOSE: There is paucity of data on patient-perceived outcomes of bleomycin sclerotherapy for low-flow vascular malformations. In this study, the long-term outcomes of bleomycin sclerotherapy were investigated in terms of quality of life (QoL) and patient-perceived changes in health. MATERIALS AND METHODS: A cohort of Dutch patients with vascular malformations treated with bleomycin sclerotherapy (June 2010-November 2015) completed a questionnaire evaluating disease symptoms, QoL (Short Form 36), patient-perceived change in health status (Global Rating of Change scales) and treatment satisfaction. QoL was assessed for the patient's status before and after treatment and was analyzed relative to an age and sex-matched Dutch reference population. Predictive factors associated with QoL and patient-perceived improvement in overall health status were assessed using multivariable linear and logistic regression analyses, respectively. RESULTS: Seventy-seven patients, with a median follow-up of 22 months, were enrolled. About half of the respondents (49.3%) indicated that they perceived (any form of) improvement in their overall health status. Most often improved were the specific health aspects 'pain' (54.5%) and 'overall severity of symptoms' (57.1%). No factors were significantly predictive for patient-perceived improvement in health with respect to the vascular malformation. Impairment in work- or study-related activities prior to sclerotherapy was found to negatively impact physical QoL at follow-up (p = 0.03). CONCLUSION: Approximately half of patients with low-flow vascular malformations indicate an improvement in overall health status following bleomycin sclerotherapy, particularly concerning pain and severity of symptoms. However, most patients only perceived little to moderate improvement to their health and desire further treatment.


Assuntos
Bleomicina/administração & dosagem , Anormalidades Linfáticas/terapia , Satisfação do Paciente , Qualidade de Vida/psicologia , Escleroterapia/métodos , Malformações Vasculares/terapia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Anormalidades Linfáticas/psicologia , Masculino , Pessoa de Meia-Idade , Países Baixos , Prognóstico , Estudos Retrospectivos , Escleroterapia/psicologia , Inquéritos e Questionários , Resultado do Tratamento , Malformações Vasculares/psicologia
16.
J Med Case Rep ; 12(1): 167, 2018 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-29903033

RESUMO

BACKGROUND: Lymphatic malformations are histologically benign vascular structures that vary in anatomic lesion and size. Extensive head and neck lymphatic malformations may be life-threatening. In the present study, we described three difficult-to-treat infants with giant cervico-mediastinal lymphatic malformations accompanied by severe respiratory distress. CASE PRESENTATIONS: Case 1. A Korean girl born at a gestational age of 37 weeks and weighing 2920 g had a large cervical mass compressing the trachea. Despite initial OK-432 sclerotherapy, the mass extended over the contralateral retropharyngeal space and mediastinum. Although the cervical mass was completely excised, our patient was not weaned off the ventilator. The mediastinal lymphatic malformation was excised, and our patient underwent continued intensive respiratory care with nasal continuous positive airway pressure for 6 months. She is now 5 years old and doing well without any sequelae. Case 2. A 5-month-old Korean boy showed respiratory difficulty with feeding intolerance after partial excision of a neck lymphatic malformation. We found that the remnant cervical mass had grown into the retropharyngeal space and mediastinum. After a second operation for the cervico-mediastinal mass, he experienced severe respiratory difficulty requiring ventilator care for 6 months. However, he died from central-line fungal sepsis. Case 3. A 30-day-old Korean girl was referred for remnant lymphatic malformation after partial excision. The cervical mass extended to the mediastinum and occupied half of the thoracic cavity, encasing all of the major vessels. After surgical excision, she underwent ventilator care and pleurodesis three times with doxycycline for recurrent pleural effusion. At the age of 26 months, she was weaned off supplementary oxygen and she showed normal development without any sequelae. CONCLUSIONS: Despite difficulties in the treatment process, combinations of delicate surgical treatment, appropriate adjuvant sclerotherapy, and intensive respiratory supportive care could result in a good outcome. However, complications due to long-term intensive care could still be considered.


Assuntos
Obstrução das Vias Respiratórias/terapia , Anormalidades Linfáticas/terapia , Obstrução das Vias Respiratórias/etiologia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Mediastino , Pescoço , Respiração Artificial , Escleroterapia , Resultado do Tratamento
17.
Rev Med Interne ; 39(10): 800-804, 2018 Oct.
Artigo em Francês | MEDLINE | ID: mdl-29627129

RESUMO

Vascular malformations are poorly recognized constitutional anomalies which arises during early childhood. Several classifications tried to draw a distinction across the different entities. Recent advances in molecular biology have contributed to the update of their nosology. Syndromic vascular malformations are an example: while Klippel-Trenaunay syndrome, Proteus or CLOVES syndrome share many common features, understanding of pathological mechanism and specially the role of the PIK3/AKT/mTOR pathway enables us to rethink their classification. Then, some syndromes associated with overgrowth and vascular malformation have been grouped under a single term: "PIK3CA-related overgrowth spectrum" (PROS), and this group continues to grow. This new approach suggests new treatment options. Rapamycin, a PIK3/AKT/mTOR pathway inhibitor, demonstrated its efficiency for some forms of PROS. Targeted therapies such as PIK3 or mTOR selective inhibitor are still in a developmental phase and results are encouraging. This is an example of personalized medicine with significant therapeutic benefit for some patients. However, genotype relation with therapeutic efficiency must be clarified and physicians should pay attention to possible negative effects of these drugs, especially for young patients.


Assuntos
Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/terapia , Malformações Vasculares/diagnóstico , Malformações Vasculares/terapia , Veias/anormalidades , Idade de Início , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Anormalidades Linfáticas/complicações , Anormalidades Linfáticas/epidemiologia , Síndrome , Malformações Vasculares/complicações , Malformações Vasculares/epidemiologia
18.
J Neurointerv Surg ; 10(3): e2, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29326377

RESUMO

An infant presented with right upper eyelid ptosis and was subsequently diagnosed with acquired Horner syndrome. Further evaluation revealed a right-sided cervicothoracic lymphatic malformation. At 13 weeks of age, the child underwent percutaneous intracystic sclerotherapy with a mixture of sodium tetradecyl sulphate and ethanol. Twenty-one weeks after initial treatment, ophthalmic examination showed complete resolution of the blepharoptosis and pupillary miosis. Percutaneous sclerotherapy not only effectively treated the space-occupying lymphatic malformation but also reversed the Horner syndrome that was presumably induced by neural tension (more likely) or compression.


Assuntos
Síndrome de Horner/diagnóstico por imagem , Síndrome de Horner/terapia , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/terapia , Escleroterapia/métodos , Blefaroptose/diagnóstico por imagem , Blefaroptose/terapia , Etanol/administração & dosagem , Humanos , Lactente , Recém-Nascido , Tetradecilsulfato de Sódio/administração & dosagem
19.
J Biophotonics ; 11(8): e201700124, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28851128

RESUMO

Lymphatic malformations are complex congenital vascular lesions composed of dilated, abnormal lymphatic channels of varying size that can result in significant esthetic and physical impairment due to relentless growth. Lymphatic malformations comprised of micro-lymphatic channels (microcystic) integrate and infiltrate normal soft tissue, leading to a locally invasive mass. Ultrasonography and magnetic resonance imaging assist in the diagnosis but are unable to detect microvasculature present in microcystic lymphatic malformations. In this review, we examine existing tools and elaborate on alternative diagnostic methods in assessing lymphatic malformations. In particular, photoacoustics, low-toxicity nanoparticles and optical clearing can overcome existing challenges in the examination of lymphatic channels in vivo. In combination with photothermal scanning and flow cytometry, Photoacoustic techniques may provide a versatile tool for lymphatic-related clinical applications, potentially leading to a single diagnostic and therapeutic platform to overcome limitations in current imaging techniques and permit targeted theranostics of microcystic lymphatic malformations.


Assuntos
Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/terapia , Diagnóstico por Imagem , Humanos , Nanomedicina , Fenômenos Ópticos
20.
Eye (Lond) ; 32(1): 152-155, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28776595

RESUMO

ObjectiveTo report the role of intralesional bleomycin as sole or adjunct therapy in the management of superficial ocular adnexal lymphatic malformations.DesignRetrospective study.ParticipantsThree patients/three eyes.MethodsRetrospective chart analysis of patients receiving intralesional bleomycin sclerotherapy as sole or adjunctive treatment for superficial ocular adnexal lymphatic malformations at a single tertiary level eye care institution.ResultsDegree of clinical regression of the lesions (graded by percentage) and resolution of symptoms and signs associated with the lesions.ConclusionsUse of intralesional bleomycin sclerotherapy appears to be an effective sole or adjunct treatment in the management of superficial ocular adnexal lymphatic malformations.


Assuntos
Bleomicina/administração & dosagem , Olho/irrigação sanguínea , Anormalidades Linfáticas/terapia , Escleroterapia/métodos , Adolescente , Adulto , Antibióticos Antineoplásicos/administração & dosagem , Pré-Escolar , Feminino , Humanos , Injeções Intralesionais , Anormalidades Linfáticas/diagnóstico , Masculino , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Malformações Vasculares/terapia
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