Lymphangioma of the urethra: A case report.

A case of urethral lymphangioma is reported. The accurate diagnosis depends on pathological examination. The patient was a 49-year-old man with symptoms of gross hematuria, frequent urination, urgency and pain. Underwent cystoscopic tumor resection. The pathological diagnosis was urethral lymphangioma. Four months after the operation, the patient had no symptoms.

Introduction

Benign urethral tumors are rare in men. Lymphangioma is a benign tumor, which can be seen in skin, mucosa and subcutaneous tissue, and is rare in other parts. They are mainly represented by polyps, which may be congenital or postnatal. Conservative treatment is generally recommended for lymphangiomas. However, if symptoms appear, urethral lymphangiomas need surgical treatment. Hence, we present a case of urethral lymphangioma and discuss its history and treatment.

Case report

The patient is a 49-year-old adult male. He was admitted to urology surgery because of gross hematuria in the whole process. The patient has frequent urination, more than 10 times a day, less urine, about 50ml each time. He has urgent urination and feels urethral orifice pain when urinating. Urine cytology confirmed hematuria. Urine bacteriological examination was negative. Urinary colour B-ultrasound and urinary CT enhancement only suggest small renal cysts and prostate calcification. Transurethral cystoscopy revealed an oval cicatricial tumor in the posterior urethra, with a size of 0.3 * 0.2 * 0.1cm. The bladder is normal. After the posterior urethral biopsy, it was seen under the microscope that the lesion was composed of large and thin-walled cavities or channels, which contained eosinophils (lymph) and few or no red blood cells. The inner wall of the vascular channel shows a relatively wide endothelial nucleus. These channels have no muscle layer around the endothelial lining and are separated by fibrous tissue bands. A small amount of prostate tissue can be seen at the cutting edge (Fig. 1). So we got the diagnosis of urethral lymphangioma. Two days later, hematuria disappeared. The transabdominal and transrectal combined colour B-ultrasound and cystoscopy after April were normal. At present, the patient has no symptoms.

(Fig. 1)

These channels have no muscle layer around the endothelial lining and are separated by fibrous tissue bands. A small amount of prostate tissue can be seen at the cutting edge.

Discussion

Benign tumors of the male urethra are very rare., They are papillary or polypoid., Urethral polyps are generally congenital. They can be located in the posterior urethra, anterior urethra and even bladder. Lymphangiomas are usually children's tumors that occur in the skin or subcutaneous stroma and are known for recurrence. Only two cases described urethral lymphangioma. One case showed hematuria and the other showed urethral stricture., Endoscopic resection was performed in both cases. Lymphangioma is a congenital malformation of unknown origin, which can be caused by the loss of connection between lymph nodes and the normal venous system. The histological characteristics of lymphangioma are the proliferation of blood vessels around the cystic structure, no junction, and the lymphoid structure is basically mature. The cystic cavity surrounded by a layer of epithelial flat cells looks like normal lymphoid epithelium.1, 2, 3, 4, 5。

Conclusion

Since lymphangioma is very rare in the urethra, it presents as urinary tract stenosis and urethral stricture. Although the recurrence rate of lymphangioma is very high, it can be treated under endoscopy. Even if it relapses again, the diagnosis and treatment are not difficult.