縦隔リンパ管腫の1例

Mediastinal Lymphangioma：Report of a Case

はじめに　縦隔リンパ管腫は比較的まれな疾患で術前診断が困難とされ1），切除術後のリンパ漏が多いと報告されている2）．われわれは未確診の縦隔囊胞性腫瘤の手術に際し，術前のMRI所見からリンパ管腫を鑑別診断にあげ，手術直前に牛乳を経口摂取させたことで合併症なく完全切除しえた症例を経験したため報告する．

A 76-year-old woman was admitted to our hospital with an abnormal shadow on a chest computed tomography （CT） scan. A chest magnetic resonance imaging （MRI） revealed an anterior mediastinal cyst of 7 cm in diameter with an internal septal-like structure, leading to the differential diagnosis of mediastinal lymphangioma. After administering milk, we performed video-assisted thoracoscopic excision of the lesion. After excision of the cyst, no cloudy fluid leakage was observed from the excised margin. Immunohistochemical analysis showed that the cells lining the cyst walls were stained positive for D2-40, therefore the lesion was diagnosed as a mediastinal lymphangioma. Mediastinal lymphangioma is rare, and postoperative lymphatic leakage is common in surgical cases. In this case, mediastinal lymphangioma was selected as the differential diagnosis based on the preoperative MRI findings, and complete resection was achieved without complications by administering milk before surgery.