Úvod: Lymfangiómy patria do skupiny benígnych vaskulárnych tumorov, ktoré majú svoj pôvod v lymfatickom tkanive. Až 90 % prípadov sa manifestuje u detí pred dovŕšením druhého roku života. U dospelých je ich prítomnosť veľmi zriedkavá. Vo väčšine prípadov sa nachádzajú v oblasti hlavy, krku a axily. Intraabodminálne lymfangiómy sú veľmi zriedkavé a predstavujú menej ako 1 % všetkých prípadov. Kazuistika: Autori prezentujú prípad 64-ročnej pacientky, ktorej bola v rámci preventívnej prehliadky diagnostikovaná intraabdominálna cystická lézia. CT vyšetrenie brucha potvrdilo cystickú léziu lokalizovanú v malom omente medzi ľavým lalokom pečene a malým zakrivením žalúdka. Pacientka bola indikovaná na laparoskopickú exstirpáciu ložiska. Histologické vyšetrenie potvrdilo klinickú diagnózu cystického lymfangiómu malého omenta. Záver: Etiopatogenéza lymfangiómov ostáva nejasná. Napriek tomu, že ide o benígne tumory, lymfangiómy majú tendenciu správať sa lokálne infiltratívne a invadujú do okolitých štruktúr. Väčšina prípadov je asymptomatická a diagnostika býva náhodná. Zlatým štandardom v liečbe ostáva kompletná chirurgická exstirpácia s mikroskopicky negatívnymi okrajmi.
Introduction: Lymphangiomas belong to the group of benign vascular tumors that originate in the lymphatic tissue. Up to 90% of cases manifest in children before the second year of life. In adults, their presence is very rare. In most cases, they are located in the head, neck and axilla. Intra-abdominal lymphangiomas are very rare and represent less than 1% of all cases. Case report: The authors present the case of a 64-year-old female patient diagnosed with an intra-abdominal cystic lesion following a routine examination. A CT scan of the abdomen confirmed a cystic lesion located in the lesser omentum between the left lobe of the liver and the lesser curvature of the stomach. The patient was scheduled for laparoscopic exstirpation of the lesion. Histological examination confirmed the clinical diagnosis of cystic lymphangioma of the lesser omentum. Conclusion: The etiopathogenesis of lymphangiomas remains unclear. Despite the fact that they are benign tumors, lymphangiomas tend to have an infiltrative pattern of growth, invading surrounding structures. The majority of cases are asymptomatic and the diagnosis is incidental. The gold standard in treatment remains complete surgical extirpation with microscopically negative margins.
- MeSH
- diferenciální diagnóza MeSH
- imunohistochemie metody MeSH
- lidé MeSH
- lymfangiom cystický * chirurgie diagnostické zobrazování patologie MeSH
- miniinvazivní chirurgické výkony metody MeSH
- náhodný nález MeSH
- omentum chirurgie diagnostické zobrazování patologie MeSH
- peritoneální nádory chirurgie diagnostické zobrazování patologie MeSH
- počítačová rentgenová tomografie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE: The liver is the most widely used site for pancreatic islet transplantation. However, several site-specific limitations impair functional success, with instant blood-mediated inflammatory reaction being the most important. The aim of this study was to develop a preclinical model for placement of the islet graft into a highly vascularized omental flap using a fibrin gel. For this purpose, we tested islet viability by bioluminescence imaging (BLI). PROCEDURES: Pancreatic islets were isolated from luciferase-positive and luciferase-negative rats, mixed at a 1:1 ratio, placed into a plasma-thrombin bioscaffold, and transplanted in standard (10 pancreatic islets/g wt; n = 10) and marginal (4 pancreatic islets/g wt; n = 7) numbers into the omentums of syngeneic diabetic animals. For the control, 4 pancreatic islets/g were transplanted into the liver using the standard procedure (n = 7). Graft viability was tested by bioluminescence at days 14, 30, 60, and 90 post transplant. Glucose levels, intravenous glucose tolerance, and serum C-peptide were assessed regularly. RESULTS: Nonfasting glucose levels < 10 mmol/l were restored in all animals. While islet viability in the omentum was clearly detected by stable luminescence signals throughout the whole study period, no signals were detected from islets transplanted into the liver. The bioluminescence signals were highly correlated with stimulated C-peptide levels detected at 80 days post transplant. Glucose tolerance did not differ among the 3 groups. CONCLUSIONS: We successfully tested a preclinical model of islet transplantation into the greater omentum using a biocompatible scaffold made from autologous plasma and human thrombin. Both standard and marginal pancreatic islet numbers in a gel-form bioscaffold placed in the omentum restored glucose homeostasis in recipients with diabetes. Bioluminescence was shown promising as a direct proof of islet viability.
- MeSH
- krysa rodu rattus MeSH
- Langerhansovy ostrůvky diagnostické zobrazování MeSH
- luminiscenční měření metody MeSH
- molekulární zobrazování metody MeSH
- omentum diagnostické zobrazování MeSH
- přežívání štěpu fyziologie MeSH
- transplantace Langerhansových ostrůvků * MeSH
- viabilita buněk fyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
