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Papaccio M, Bernardi M, Tonegatti LG, Alberti D, Sartori E, Signorelli M. A case series of fetal lymphatic malformations and a review of the literature. J Neonatal Perinatal Med 2023; 16:747-754. [PMID: 38007678 DOI: 10.3233/npm-230160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Lymphatic malformations are rare benign developmental anomalies of the lymphatic system that can be diagnosed by prenatal ultrasound. Depending on their anatomical site and size, the lesions can cause a variety of aesthetic and functional deficits. Several treatment options are available, the most suitable is still under debate. The experience gained at our Centre and the review of the literature can be useful to improve prenatal counseling, that is challenging due to the heterogeneity of clinical presentation and treatment.
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Affiliation(s)
- M Papaccio
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Bernardi
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - L G Tonegatti
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - D Alberti
- Department of Pediatric Surgery, Spedali Civili Children's Hospital of Brescia, Brescia BS, Italy
| | - E Sartori
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
| | - M Signorelli
- Department of Obstetrics and Gynecology, University of Brescia, Brescia BS, Italy
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Diaz-Primera R, Sánchez-Jimenez R, Marin-Concha J, Mena R, Garrido-Mendez J, Mariñez M, Mena-Rivas R, Lopez A, Diaz-Rodriguez A, Mogena-Sanchez O, Almanzar R, Soto-Ravelo R. Prenatal Diagnosis of Fetal Lymphangioma: A Case Series. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1019-1026. [PMID: 34288011 DOI: 10.1002/jum.15783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Fetal lymphangioma is an uncommon congenital malformation that is mainly comprised of the subcutaneous tissue of the neck. This malformation can develop in other areas like the thoracic and axillary regions, though rarely. We report 6 consecutive cases of lymphatic malformation in a fetal center in Dominican Republic. In our case series fetal chest lymphangiomas were present in 2 fetuses. In addition, 2 cases of axillary lymphangiomas also involved the thoracic region. Adequate management by a multidiciplinary team is necessary to provide a better approach to delivery.
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Affiliation(s)
- Ramiro Diaz-Primera
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Raúl Sánchez-Jimenez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Julio Marin-Concha
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Rafael Mena
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Jose Garrido-Mendez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Manuel Mariñez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Ramon Mena-Rivas
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Ashley Lopez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Agustin Diaz-Rodriguez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Orlando Mogena-Sanchez
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Rafael Almanzar
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
| | - Rodolfo Soto-Ravelo
- Department of Maternal Fetal Medicine, Dominican Fetal Center, Centro de Obstetricia y Ginecología, Santo Domingo, Dominican Republic
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The Value of Fetal Heart Evaluation in Fetuses with Rare Congenital Lymphangiomas: A Cohort Study from a Single Tertiary Center across Two Decades (Years 1999-2020). J Clin Med 2022; 11:jcm11041035. [PMID: 35207307 PMCID: PMC8874571 DOI: 10.3390/jcm11041035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022] Open
Abstract
Lymphangiomas are uncommon, benign (from a histopathology viewpoint) malformations of the lymphatic system with thin-walled vessels; however, these tumors may be dangerous for fetal or neonatal life. They are observed in 1:6000 newborns at birth and in 1:750 spontaneous abortions. We aimed to investigate the role of fetal echocardiography in the prognosis of lymphangioma. Selected data of 19,836 pregnant women studied between 1999 and 2020 were retrospectively analyzed. In total, 32 cases of lymphangioma meeting the following criteria were further analyzed: (1) ultrasound availability from the 1st trimester of pregnancy and (2) nuchal translucency ≤ 2.5 mm. Echocardiographic findings, karyotype, size, and location of the possible lesion were juxtaposed with the clinical follow-up. The statistical analysis was performed using Statistica 13.1 software (StatSoft, Tulsa, OK, USA). Lymphangioma in the analyzed material coexisted with abnormalities in fetal echo in 78% (n = 25) of cases, especially: heart defect in 50% (n = 16) and with normal heart structure with functional changes in 28% (n = 9). Karyotype was available in 50% of the analyzed cases (n = 16). Normal cytogenetic results were observed in 62.5% (n = 10) of cases. In the remaining cases, the following were observed: Turner Syndrome: 25% (n = 4) and Down Syndrome 12.5% (n = 2). The rate of alive newborns was significantly higher among fetuses with isolated lymphangioma in comparison to those with lymphangioma associated with abnormal ECHO examination: 38.46% (n = 5) vs. 15.38% (n = 2; p = 0.037). Abnormal ECHO exam was a poor prognostic sign for fetuses with lymphangioma; therefore, we think it is important to refer these cases for detailed echocardiography in tertiary centers. Moreover, it should be highlighted that in all lymphangioma cases there was an indication to perform the karyotype assessment, as there was a high risk of aneuploidy.
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Li J, Zhong W, Geng X, Liu X, Zhang X, Wang Y, Li H. Ultrasonographic diagnosis, classification, and treatment of cervical lymphatic malformation in paediatric patients: a retrospective study. BMC Pediatr 2020; 20:441. [PMID: 32950065 PMCID: PMC7501610 DOI: 10.1186/s12887-020-02337-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/10/2020] [Indexed: 02/06/2023] Open
Abstract
Background To explore the imaging features, key diagnostic points, classification, treatment, and prognosis of cervical lymphatic malformation. Methods Overall, 320 patients diagnosed with cervical lymphatic malformation were retrospectively analysed in our hospital between 1 January 2014 and 31 December 2017. Imaging modalities included colour Doppler ultrasound, magnetic resonance imaging, and contrast-enhanced computed tomography. Cervical lymphatic malformations were classified by cyst diameter. Treatments included interventional therapy, surgery, and expectant treatment. Results Cervical lymphatic malformation was identified in 320 of 1192 patients with lymphatic malformation. Four were excluded due to misdiagnosis by ultrasonography. Cervical lymphatic malformation was classified as mixed, macrocystic, and microcystic in 184 (57.5%), 117 (36.56%), and 19 (5.94%) patients, respectively. Sixty-four (20%), ten (3.12%), seven (2.19%), and three (0.94%) patients experienced intracystic haemorrhage, infection, concurrent intracystic haemorrhage and infection, and calcification, respectively. Among 260 (81.25%) patients who underwent interventional sclerotherapy, 163 (50.94%) received it once and 96 (30%) received it two or more times. Twenty-eight (8.75%), five (1.56%), and 27 (8.44%) patients underwent surgical resection, interventional sclerotherapy plus surgery, and expectant management, respectively. Conclusions Ultrasonography is useful for diagnosing definite cervical lymphatic malformation. Interventional therapy is the first choice for children with confirmed cervical lymphatic malformation.
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Affiliation(s)
- Jiaoling Li
- Department of Ultrasound, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China.
| | - Wei Zhong
- Neonatal Intensive Care Unit, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China
| | - Xiuping Geng
- Department of Ultrasound, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China
| | - Xiaofang Liu
- Department of Ultrasound, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China
| | - Xiangxiang Zhang
- Department of Ultrasound, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China
| | - Yurun Wang
- Department of Ultrasound, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China
| | - Haibo Li
- Department of Invasive Technology, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Jinsui Road 9, Guangzhou, 510623, China
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Yuan Y, Tai W, Xu P, Fu Z, Wang X, Long W, Guo X, Ji C, Zhang L, Zhang Y, Wen J. Association of maternal serum 25-hydroxyvitamin D concentrations with risk of preeclampsia: a nested case-control study and meta-analysis. J Matern Fetal Neonatal Med 2019; 34:1576-1585. [PMID: 31284795 DOI: 10.1080/14767058.2019.1640675] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Whether the maternal vitamin D deficiency is associated with preeclampsia is still an argument. We aimed to assess the association between maternal serum 25-hydroxyvitamin D [25(OH)D] concentrations and risk of preeclampsia in a Chinese population and systematically evaluate published evidence on this association. METHODS We conducted a nested case-control study involving 122 pregnant women with preeclampsia and 488 pregnant women whose blood pressure was within the normal range (as controls). For further meta-analysis, 20 studies and our study were included for the final pooled analysis, involving 39,031 participants and 3305 preeclampsia cases with various ethnicities. RESULTS The results showed that 65.6% of women with preeclampsia had serum 25(OH)D concentrations <50.0 nmol L-1 compared with 55.3% of women in controls. The 25(OH)D concentrations were significantly lower in women with preeclampsia than controls [Median (IQR), women with preeclampsia versus controls: 43.3 (35.5, 55.2) versus 47.5 (37.6, 60.4) nmol L-1, p = .014]. For women with 25(OH)D concentrations <50.0 nmol L-1, they had a 65% increase in preeclampsia risk (95% CI = 1.02-2.69), as compared with women with 25(OH)D concentrations from 50.0 to 74.9 nmol L-1. Further, meta-analysis showed that low 25(OH)D concentrations were associated with a significantly increased risk of preeclampsia by 62% (pooled OR = 1.62, 95%CI = 1.36-1.94), and the risk effect of low 25(OH)D concentrations existed in most subgroups. CONCLUSIONS Low 25(OH)D concentration in pregnancy was significantly associated with preeclampsia risk, and it may serve as biomarkers for the surveillance of high-risk pregnant women.
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Affiliation(s)
- Yingdi Yuan
- Department of Pediatrics, the First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang (Lianyungang Clinical College of Nanjing Medical University), Lianyungang, China.,Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Wen Tai
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Pengfei Xu
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Ziyi Fu
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xiaolei Wang
- Department of Neonatology, Wuxi Children's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Wei Long
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xirong Guo
- Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenbo Ji
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Le Zhang
- Department of Neonatology, Wuxi Children's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Yue Zhang
- School of Information Management, Nanjing University, Nanjing, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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Jiao-ling L, Hai-ying W, Wei Z, Jin-rong L, Kun-shan C, Qian F. Treatment and prognosis of fetal lymphangioma. Eur J Obstet Gynecol Reprod Biol 2018; 231:274-279. [DOI: 10.1016/j.ejogrb.2018.10.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/12/2018] [Indexed: 11/25/2022]
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Li JL, Hai-ying W, Liu JR, He QM, Chen KS, Yang J, Qian F. Fetal Lymphangioma: Prenatal diagnosis on ultrasound, treatment, and prognosis. Eur J Obstet Gynecol Reprod Biol 2018; 231:268-273. [DOI: 10.1016/j.ejogrb.2018.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/25/2018] [Accepted: 10/06/2018] [Indexed: 10/28/2022]
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