Αdnexal cystic lymphangiomas in patients with massive leiomyomatous uterus: a not so uncommon finding on pelvic MRI.

Autor: Bourgioti C; Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vassilisis Sofias Ave, Athens, 11528, Greece. charisbourgioti@yahoo.com., Chatoupis K; Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vassilisis Sofias Ave, Athens, 11528, Greece., Tzavara C; Department of Health, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 25 Alexandroupoleos Str, Athens, 11527, Greece., Zafeiropoulou K; Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vassilisis Sofias Ave, Athens, 11528, Greece., Panourgias E; Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vassilisis Sofias Ave, Athens, 11528, Greece., Antoniou A; Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vassilisis Sofias Ave, Athens, 11528, Greece., Moulopoulos LA; Department of Radiology, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vassilisis Sofias Ave, Athens, 11528, Greece.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2020 Feb; Vol. 45 (2), pp. 537-546.
DOI: 10.1007/s00261-019-02106-z
Abstrakt: Purpose: To investigate any association between the presence of an adnexal cystic lymphangioma (ACL) and an enlarged leiomyomatous uterus.
Methods: A retrospective observational study was conducted by two expert radiologists using a 10-year MRI database (2008-2018); 85 patients (mean age: 45.5 years ± 10.9) were considered eligible due to the presence of a single (n = 31) or multiple (n = 54) leiomyomas causing distortion of the uterine contour and uterine enlargement. The association of specific leiomyoma features (longest diameter (Dmax), location, number) and uterine volume with the presence of ACL was statistically tested. Diagnosis of ACL was based on typical imaging features (n = 14) and intraoperative/histological findings (n = 3).
Results: ACL (unilateral = 9, bilateral = 8) was recorded in 17/85 (20%) of patients; it was more frequently observed when the largest leiomyoma was located in the uterine fundus (33.3%). Patients with ACL had significantly more leiomyomas (median: 5 vs. 2, p = 0.043), greater Dmax of largest leiomyoma (median: 13.3 vs. 7.2 cm, p < 0.001), and larger uterine volumes (median: 676.7 vs. 223.1 cm 3 , p < 0.001) compared to patients without ACL. ROC curve analysis for a number of leiomyomas showed that the optimal cut-off for the prediction of ACL was the presence of 5 leiomyomas with 53.8% sensitivity and 84% specificity (AUC = 0.65, 95% CI 0.51-0.83, p = 0.049), Dmax of largest leiomyoma 9.1 cm with 76.5% sensitivity and 77.9% specificity (AUC = 0.83, 95% CI 0.73-0.94, p < 0.001), and uterine volume 311 cm 3 with 71% sensitivity and 75% specificity (AUC = 0.79, 95% CI 0.66-0.92, p < 0.001).
Conclusions: The presence of ACL is significantly associated with number of leiomyomas, Dmax of largest leiomyoma, and uterine volume; prospective evaluation of our results is needed to investigate its clinical significance.
Databáze: MEDLINE
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