Clinical Features and Prognosis of Generalized Lymphatic Anomaly, Kaposiform Lymphangiomatosis, and Gorham-Stout Disease

Michio Ozeki, Akihiro Fujino, Kentaro Matsuoka, Shunsuke Nosaka, Tatsuo Kuroda, Toshiyuki Fukao

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: Complex lymphatic anomalies are intractable lymphatic disorders, including generalized lymphatic anomaly (GLA), Gorham-Stout disease (GSD), and kaposiform lymphangiomatosis (KLA). The etiology of these diseases remains unknown and diagnosis is confused by their similar clinical findings. This study aimed to clarify the differences in clinical features and prognosis among GLA, KLA, and GSD, in Japanese patients. Procedure: Clinical features, radiological and pathological findings, treatment, and prognosis of patients were obtained from a questionnaire sent to 39 Japanese hospitals. We divided the patients into three groups according to radiological findings of bone lesions and pathology. Differences in clinical findings and prognosis were analyzed. Results: Eighty-five patients were registered: 35 GLA, 9 KLA, and 41 GSD. Disease onset was more common in the first two decades of life (69 cases). In GSD, osteolytic lesions were progressive and consecutive. In GLA and KLA, 18 patients had osteolytic lesions that were multifocal and nonprogressive osteolysis. Thoracic symptoms, splenic involvement, and ascites were more frequent in GLA and KLA than in GSD. Hemorrhagic pericardial and pleural effusions were more frequent in KLA than GLA. GSD had a significantly favorable outcome compared with combined GLA and KLA (P = 0.0005). KLA had a significantly poorer outcome than GLA (P = 0.0268). Conclusions: This survey revealed the clinical features and prognosis of patients with GLA, KLA, and GSD. Early diagnosis and treatment of KLA are crucial because KLA has high mortality. Further prospective studies to risk-stratify complex lymphatic anomalies and optimize management for KLA are urgently needed.

Original languageEnglish
Pages (from-to)832-838
Number of pages7
JournalPediatric Blood and Cancer
Volume63
Issue number5
DOIs
Publication statusPublished - 2016 May 1

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Essential Osteolysis
Osteolysis
Pericardial Effusion
Pleural Effusion
Ascites
Early Diagnosis
Thorax
Prospective Studies
Pathology
Bone and Bones
Mortality

Keywords

  • Complex lymphatic anomaly
  • Generalized lymphatic anomaly
  • Gorham-Stout disease
  • Kaposiform lymphangiomatosis
  • Lymphatic malformation
  • Osteolysis

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Clinical Features and Prognosis of Generalized Lymphatic Anomaly, Kaposiform Lymphangiomatosis, and Gorham-Stout Disease. / Ozeki, Michio; Fujino, Akihiro; Matsuoka, Kentaro; Nosaka, Shunsuke; Kuroda, Tatsuo; Fukao, Toshiyuki.

In: Pediatric Blood and Cancer, Vol. 63, No. 5, 01.05.2016, p. 832-838.

Research output: Contribution to journalArticle

Ozeki, Michio ; Fujino, Akihiro ; Matsuoka, Kentaro ; Nosaka, Shunsuke ; Kuroda, Tatsuo ; Fukao, Toshiyuki. / Clinical Features and Prognosis of Generalized Lymphatic Anomaly, Kaposiform Lymphangiomatosis, and Gorham-Stout Disease. In: Pediatric Blood and Cancer. 2016 ; Vol. 63, No. 5. pp. 832-838.
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AU - Nosaka, Shunsuke

AU - Kuroda, Tatsuo

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AB - Background: Complex lymphatic anomalies are intractable lymphatic disorders, including generalized lymphatic anomaly (GLA), Gorham-Stout disease (GSD), and kaposiform lymphangiomatosis (KLA). The etiology of these diseases remains unknown and diagnosis is confused by their similar clinical findings. This study aimed to clarify the differences in clinical features and prognosis among GLA, KLA, and GSD, in Japanese patients. Procedure: Clinical features, radiological and pathological findings, treatment, and prognosis of patients were obtained from a questionnaire sent to 39 Japanese hospitals. We divided the patients into three groups according to radiological findings of bone lesions and pathology. Differences in clinical findings and prognosis were analyzed. Results: Eighty-five patients were registered: 35 GLA, 9 KLA, and 41 GSD. Disease onset was more common in the first two decades of life (69 cases). In GSD, osteolytic lesions were progressive and consecutive. In GLA and KLA, 18 patients had osteolytic lesions that were multifocal and nonprogressive osteolysis. Thoracic symptoms, splenic involvement, and ascites were more frequent in GLA and KLA than in GSD. Hemorrhagic pericardial and pleural effusions were more frequent in KLA than GLA. GSD had a significantly favorable outcome compared with combined GLA and KLA (P = 0.0005). KLA had a significantly poorer outcome than GLA (P = 0.0268). Conclusions: This survey revealed the clinical features and prognosis of patients with GLA, KLA, and GSD. Early diagnosis and treatment of KLA are crucial because KLA has high mortality. Further prospective studies to risk-stratify complex lymphatic anomalies and optimize management for KLA are urgently needed.

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KW - Lymphatic malformation

KW - Osteolysis

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