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Papillary transitional cell carcinoma of the bladder with lymphangiectasia in an 8-year-old boy.
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Intestinal leakage of technetium-99m-MDP in primary intestinal lymphangiectasia.
We present a case in which a patient with primary intestinal lymphangiectasia demonstrated abnormal intestinal accumulation of tracer during 99mTc-methylene diphosphonate (MDP) skeletal scintigraphy. Early intestinal leakage with gradual colonic migration and concentration was confirmed by repeat bone scan with serial acquisitions. The mechanism for the intestinal localization of 99mTc-MDP seen in this patient is not clear. Thus, intestinal lymphangiectasia can be a cause for extra-osseous localization of bone scan agents in the intestine.
Subcutaneous accumulation of chyle after thoracic duct ligation in a dog.
A 3.5-year-old female German Shepherd Dog developed subcutaneous accumulation of chyle in a hind limb after ligation of the thoracic duct for treatment of chylothorax. Lymphangiography revealed severe lymphangiectasia in the abdomen and left inguinal region. Although the pleural effusion resolved, the subcutaneous accumulation of chyle continued even after medical and surgical treatment, which included transplantation of the greater omentum into the subcutaneous tissues of the affected limb. Alternate lymphaticovenous pathways usually develop in dogs after thoracic duct ligation. These apparently did not develop in this dog, resulting in retrograde flow of chylous fluid into the hind limb. To the authors' knowledge, this is a previously unrecognized complication of thoracic duct ligation for treatment of chylothorax in dogs.
Intestinal lymphangiectasia in a dog.
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[Diseases of the lymphatic vessel system and of the lymph circulation].
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[Primary intestinal lymphangiectasia in children. Report of 3 cases].
It report three cases of Primary Intestinal Lymphangiectasia that presented the common symptoms of diarrhea, oedema and hipoalbuminaemia in which we could observed the clinics variations that can to present this entity. It demonstrated the importance of the intestinal biopsy to get a correct diagnosis just as the essencial of use of the medium chain triglycerides with the restriction of the common fast, to recuperate these patients.
[Practical uses of intestinal biopsy in pediatrics].
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A syndrome of congenital lymphedema of the upper extremity and associated systemic lymphatic malformations.
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[The diagnostic value and risks of small bowel biopsy: an assessment in 80 patients (author's transl)].
Small bowel biopsy is a routine procedure used mainly in the evaluation of malabsorption. The Crosby-Kugler capsule, which permits the performance of just one biopsy per session and hydraulic biopsy tubes, permitting multiple biopsies from any level of the small bowel, have been in use now with several modifications for about 20 years. The diagnostic range and risks of these tools are described briefly in this paper and discussed in the light of our own experience in 80 patients. In accordance with the experience of others, we found that small bowel biopsy was accompanied by only a few minor complications and we consider it a valuable procedure in clinical diagnosis and experimental research.
The pulmonary vascular pathology of experimental radiation pneumonitis.
Dogs exposed by inhalation to an aerosol of fused aluminosilicate particles containing the radionuclide yttrium 90 developed radiation pneumonitis. The aerosol had a mean aerodynamic diameter of 0.8 to 1.2 mu with a sigma(g) of 1.6 to 1.9. The 36 dogs included in this report received initial lung burdens of 590 to 5200 muCi (90)Y/kg body weight and died at 7.5 to 237 days after exposure with total cumulative radiation doses to lung of 9300 to 70,000 rads. Vascular lesions in the lungs were marked. Early changes included edema of vessel walls with leukocytic infiltration, dilation of perivascular lymphatic channels, and occasional periarterial lymphangiectasia. Splitting and reduplication of the elastica were occasionally visible. The most striking inflammatory vascular changes were vasculitis and fibrinoid necrosis, which involved bronchial and pulmonary vessels at some-what different times. Such lesions were often segmental and included fibrinoid necrosis and a variable leukocytic infiltrate in and around the actively involved lesions. Vasculitis was most commonly seen in small muscular arterioles, but veins and venules also occasionally exhibited similar inflammatory lesions. Progressive vascular inflammation led to extensive intimal proliferative lesions and fibromuscular hypertrophy with eventual fibrous accumulation around blood vessels, obliterative intimal and medial thickening, and luminal narrowing. Such changes eventually formed the morphologic basis for increased pulmonary vascular resistance and the development of cardiac dilation and hypertrophy reflecting pulmonary hypertension.
[Anomalies of umbilical vein in the fetus. A case report and review of the literature].
Abnormal connexion of the umbilical vein in the inferior vena cava was diagnosed in a fetus at 18 weeks' gestation. Associated anomalies included nuchal and axillary lymphangiectasia, hypertrophic cardiomyopathy and hepatomegaly. Neonatal death occurred after spontaneous vaginal delivery at 25 weeks. A review of the literature summarizes the diagnostic criteria and associated anomalies.
[Protein-losing gastroenteropathy].
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[Idiopathic intestinal lymphangiectasia with hypoproteinemia. Unusual combination of complete diagnosis and ineffective therapy (author's transl)].
This case illustrates the difficulties which occasionally are encountered in diagnosing and treating small intestinal diseases. The delay in diagnosis was due to the fact that symptoms started in 1950 but the disease was not described until 11 years later. Once the diagnosis was established, there was an unexplained failure of response to appropriate therapy.
A case of the yellow nail syndrome associated with massive chylous ascites, pleural and pericardial effusions.
A 26-year-old male patient with a history of chronic peripheral lymphedema, yellowish coloured slow growing nails and pleural effusions since early childhood is described. After 23 years he developed a chylous ascites and scintigraphy with technetium-99m labeled albumin clearly demonstrated a diffuse protein loss involving the whole jejunum and ileum. Subsequent jejunal and duodenal biopsies showed the typical histological findings of intestinal lymphangiectasia thereby confirming a diffuse intestinal lymphatic damage. In addition to the gastrointestional symptoms the patient developed a pericardial effusion diagnosed by echocardiographic imaging. Dietary treatment with middle chained triglycerides and intravenous human albumin supplementation was followed by the reduction of the ascites and improvement of the peripheral lymphedema. To our knowledge this is the first description of the yellow nail syndrome associated with a diffuse lymphangiectasia involving the whole small bowel.
The oral manifestations of intestinal lymphangiectasia: case report.
Intestinal lymphangiectasia is a rare autosomal dominant disorder or acquired condition that leads to lymph obstruction, poor chyle transport, and concomitant problems of hypoproteinemia, lymphocytopenia, hypogammaglobulinemia, and peripheral edema. Patients develop diarrhea, steatorrhea, and hypocalcemia secondary to fat-soluble vitamin malabsorption. Treatment is a restrictive diet of low fat, medium chain triglycerides. Oral manifestations are gingivitis due to poor PMN function and enamel defects due to poor calcium absorption. A case of a 14-year-old boy with both gingival and enamel problems secondary to intestinal lymphangiectasia is reported.
[Congenital pulmonary lymphangiectasia with chylothorax. Different evolution of 2 cases with severe neonatal respiratory distress].
The Authors report on 2 cases of congenital pulmonary lymphangiectasia with chylothorax and severe respiratory distress which were characterized by a different clinic course. One of the newborns, in fact, died after a few days of life, while the other has survived with the complete regression of chylothorax. The Authors also add some physiopathologic remarks about pulmonary lymphatic circulation, in order to focus the different evolution of the 2 cases and the pulmonary lymphangiectasia treatment.