When abdominal form of lymphosarcoma in children first and mandatory in complex diagnostic studies should be ultrasound. The table presents data on the frequency of occurrence of different variants of tumor localization.
Zhelutska primary lesion is rare in children, unlike adults, who defeated zhelutska 53.5% of patients with lymphosarcoma. X-ray picture of lymphosarcoma zhelutska characterized by thickening of the mucous folds, chaotic orientation, rigidity of the wall at the site lesions, impaired motility and evakuatsr – function. Ultrasound pictures of stomach lesions in children characterized by an uneven wall thickening zhelutska from 1 to 3-5 cm, loss of normal layered wall structure, deformation due to the stomach tumor, the appearance of metastases in regional lymph nodes.
X-ray picture of defeat loops of intestines characterized by great length (10-25 cm or more), irregular narrowing of the intestine. Marked unevenness and blurred contours, filling defects of irregular shape, yield a contrast agent inside the contours of the intestinal lumen at its ulceration. The affected portion of intestine is surrounded by “emptiness”, adjacent loop guts raztsvinuty tumor conglomerate. By ultrasound in the abdomen revealed a heterogeneous tumor site with uneven bumpy circuits centered opretselyaetsya irregularly narrowed lumen not involved in peristalsis. Lymph nodes of the abdominal cavity without involvement in the intestinal tube is characterized by displacement, apart of the bowel loops (explains the symptom of “emptiness”) and smoothed contours of its adjacent loops.
When ultrasound revealed separate tumor nodules of low density, rounded from 2 to 10 cm, biased the study. Most of the patients with abdominal lymph form – sarcoma determined the presence of free fluid in the abdominal cavity. In 27% of cases the tumor process applicable to the bodies of the thoracic cavity in the form of separate lesions of the pleura, pleural and lymph nodes (20%), lymph nodes (12%). It should be emphasized that the isolated lesion of the intestinal tube involvement in the chest cavity is not marked. At ultrasound focal parenchymal liver diagnosed in 7.4% of patients, kidney – 11%, spleen – 18%, pancreas – in 5%, lymph node gate liver and spleen in 28%, renal failure goal in 14%, lymph nodes along the main vessels – 11%. Most of the metastases are diagnosed within the first 1.5 years.
Metastatic lesion of the chest cavity, abdominal cavity and retroperitoneal space, the skeleton is defined in 36, 34, 7% of patients, respectively. To establish the diagnosis, determine the extent of the process observations mobile tumors (up to 80 cm, image area of the tumor on the radiograph) is necessary and sufficient: abdominal ultrasound in conjunction with excretory urography, radionukltsts – tion of the liver, kidney, retroperitoneal lymph nodes, chest X-ray four projections. In identifying fixed tumor.