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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">cfpd</journal-id><journal-title-group><journal-title xml:lang="ru">Бюллетень физиологии и патологии дыхания</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin Physiology and Pathology of Respiration</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1998-5029</issn><publisher><publisher-name>Дальневосточный научный центр физиологии и патологии дыхания</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.36604/1998-5029-2022-83-100-106</article-id><article-id custom-type="elpub" pub-id-type="custom">cfpd-1009</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБМЕН ОПЫТОМ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EXPERIENCE EXCHANGE</subject></subj-group></article-categories><title-group><article-title>Кистозная мальформация (лимфангиома) грудного лимфатического протока (особенности клинико-рентгенологической диагностики, краткий обзор литературы)</article-title><trans-title-group xml:lang="en"><trans-title>Cystic malformation (lymphangioma) of the thoracic lymphatic duct (peculiarities of clinical and radiological diagnosis, a brief review)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Леншин</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lenshin</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анатолий Васильевич Леншин, д-р мед. наук, профессор, ведущий научный сотрудник, врач-рентгенолог</p><p>лаборатория функциональных методов исследования дыхательной системы</p><p>отделение лучевой диагностики</p><p>675000</p><p>ул. Калинина, 22</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Anatoliy V. Lenshin, MD, PhD, DSc (Med.), Professor, Roentgenologist, Leading Staff Scientist</p><p>Laboratory of Functional Research of Respiratory System</p><p>675000</p><p>22 Kalinina Str.</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">lenshin42@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ильин</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Il’in</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Андрей Валерьевич Ильин, канд. мед. наук, зав. отделением,  врач-рентгенолог</p><p>отделение лучевой диагностики</p><p>675000</p><p>ул. Калинина, 22</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Andrey V. Il’in, MD, PhD (Med.), Roentgenologist, Head of Department</p><p>Department of X-Ray Diagnostics</p><p>675000</p><p>22 Kalinina Str.</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">alero82@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Игнатьева</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ignat’eva</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Александровна Игнатьева, врач-рентгенолог,  аспирант</p><p>отделение лучевой диагностики</p><p>лаборатория функциональных методов исследования дыхательной системы</p><p>675000</p><p>ул. Калинина, 22</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Elena A. Ignat’eva, MD, Roentgenologist, Postgraduate Student</p><p>Department of X-Ray Diagnostics</p><p>Laboratory of Functional Research of Respiratory System</p><p>675000</p><p>22 Kalinina Str.</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">ignatyevalena6618@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крайнов</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kraynov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сергей Александрович Крайнов, врач-рентгенолог</p><p>отделение лучевой диагностики</p><p>675000</p><p>ул. Калинина, 22</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Sergey A. Kraynov, MD, Roentgenologist</p><p>Department of X-Ray Diagnostics</p><p>675000</p><p>22 Kalinina Str.</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">dncfpd@dncfpd.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Перельман</surname><given-names>Ю. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Perelman</surname><given-names>J. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Юлий Михайлович Перельман, член-корреспондент, д-р мед. наук, профессор, зам. директора по научной работе, зав. лабораторией</p><p>лаборатория функциональных методов исследования дыхательной системы</p><p>675000</p><p>ул. Калинина, 22</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Juliy M. Perelman, MD, PhD, DSc (Med.), Corresponding member, Рrofessor, Deputy Director on Scientific Work, Head of Laboratory</p><p>Laboratory of Functional Research of Respiratory System</p><p>675000</p><p>22 Kalinina Str.</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">jperelman@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания»</institution></aff><aff xml:lang="en"><institution>Far Eastern Scientific Center of Physiology and Pathology of Respiration</institution></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания»; РАН</institution></aff><aff xml:lang="en"><institution>Far Eastern Scientific Center of Physiology and Pathology of Respiration; RAS</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>24</day><month>04</month><year>2022</year></pub-date><volume>0</volume><issue>83</issue><fpage>100</fpage><lpage>106</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Леншин А.В., Ильин А.В., Игнатьева Е.А., Крайнов С.А., Перельман Ю.М., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Леншин А.В., Ильин А.В., Игнатьева Е.А., Крайнов С.А., Перельман Ю.М.</copyright-holder><copyright-holder xml:lang="en">Lenshin A.V., Il’in A.V., Ignat’eva E.A., Kraynov S.A., Perelman J.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://cfpd.elpub.ru/jour/article/view/1009">https://cfpd.elpub.ru/jour/article/view/1009</self-uri><abstract><sec><title>   Введение</title><p>   Введение. Грудной лимфатический проток в верхней половине туловища собирает лимфу от левого легкого, левой половины сердца, стенок левой половины грудной клетки, от левой верхней конечности и левой половины шеи и головы. Поэтому левосторонняя локализация  выявленных патологических изменений, с вовлечением в процесс одновременно средостения и шеи, может быть признаком поражения грудного лимфатического протока (по месту расположения), а значит залогом успешной диагностики заболевания.</p></sec><sec><title>   Цель</title><p>   Цель. Демонстрация современных возможностей клинико-рентгенологической диагностики кистозной мальформации грудного лимфатического протока (КМГЛП).</p></sec><sec><title>   Результаты</title><p>   Результаты. В литературе патология грудного лимфатического протока обозначается двумя терминами: «лимфангиома» и «кистозная мальформация грудного лимфатического протока». По общепризнанной классификация сосудистых образований ISSVA (принята на 20 конференции ISSVA в Мельбурне в апреле 2014 года, последний пересмотр – в мае 2018 года), термин «лимфангиома» применительно к лимфатическим мальформациям считается устаревшим, рекомендуется его использование для истинных доброкачественных опухолей лимфатических сосудов. КМГЛП – доброкачественные, крайне редко встречающиеся лимфососудистые поражения, возникающие в результате эмбриологических нарушений (слабости стенки протока и клапанного механизма) в развитии лимфатической системы. Медиана распространённости составляет менее 1 % среди всех кистозных образований средостения. Эффективная неинвазивная диагностика при первичном обращении пациента уже на амбулаторном этапе заслуживает профессиональной оценки. Приведено собственное клинико-рентгенологическое наблюдение пациентки 26 лет без особых клинических проявлений, у которой объёмные изменения в средостении слева выявлены при выполнении плановой флюорографии. Уточнён характер (рентгеносемиотика) предоперационной визуализации с применением компьютерной томографии. Проведено сопоставление выявленных рентгенологических и патологоанатомических изменений.</p></sec><sec><title>   Заключение</title><p>   Заключение. КМГЛП – врожденные лимфатические аномалии, более частые и симптоматические у детей. У пациентов старшего возраста чаще всего диагностируются приобретенные и бессимптомные КМГЛП. Логистика современных технологий визуализации позволяет успешно диагностировать такое редкое заболевание, как КМГЛП, уже на этапе первичного обращения пациента к врачу.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>   Introduction</title><p>   Introduction. The thoracic lymphatic duct in the upper half of the body collects lymph from the left lung, the left half of the heart, the walls of the left half of the chest, from the left upper limb and the left half of the neck and head. Therefore, the left-sided localization of the revealed pathological changes, with the involvement of the mediastinum and neck in the process at the same time, can be a sign of damage to the thoracic lymphatic duct (at the location), and therefore the key to a successful diagnosis of the disease.</p></sec><sec><title>   Aim</title><p>   Aim. Demonstration of modern possibilities of clinical and radiological diagnosis of cystic malformation of the thoracic lymphatic duct (CMTLD).</p></sec><sec><title>   Results</title><p>   Results. In the literature, the pathology of the thoracic lymphatic duct is designated by two terms: “lymphangioma” and “cystic malformation of the thoracic lymphatic duct”. According to the generally accepted classification of vascular formations ISSVA (adopted at the 20th ISSVA conference in Melbourne in April 2014, last revised in May 2018), the term “lymphangioma” with regard to lymphatic malformations is considered obsolete, its use is recommended for true benign tumors of the lymphatic vessels. CMTLD – benign, extremely rare lymphovascular lesions resulting from embryological disorders (weakness of the duct wall and valve mechanism) in the development of the lymphatic system. The median prevalence is less than 1 % among all mediastinal cystic formations. Effective non-invasive diagnostics at the initial visit of the patient already at the outpatient stage deserves professional evaluation. We present the own clinical and radiological observation of a 26-year-old patient without any special clinical manifestations, in whom volumetric changes in the mediastinum on the left were detected during routine fluorography. The nature (X-ray semiotics) of preoperative imaging using computed tomography has been clarified. The revealed X-ray and pathoanatomical changes were compared.</p></sec><sec><title>   Conclusion</title><p>   Conclusion. CMTLD – congenital lymphatic anomalies, more frequent and symptomatic in children. In older patients, acquired and asymptomatic CMTLD are most often diagnosed. The logistics of modern imaging technologies makes it possible to successfully diagnose such a rare disease as CMTLD already at the stage of the patient’s initial visit to the doctor.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>кистозная мальформация грудного лимфатического протока</kwd><kwd>мультиспиральная компьютерная томография</kwd><kwd>постпроцессинговая обработка изображений</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cystic malformation of the thoracic lymphatic duct</kwd><kwd>multispiral computed tomography</kwd><kwd>post-processing imaging</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование проводилось без участия спонсоров</funding-statement><funding-statement xml:lang="en">This study was not sponsored</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Monroe E. J. 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