Pancreatic lymphangioma: CT, MRI, and angiographic features

Peripancreatic cystic lymphangioma diagnosed by endoscopic ultrasound/fine-needle aspiration: a rare mesenchymal tumour

A 73-year-old man presented with a 5-month history of intermittent nausea, vomiting, central abdominal discomfort and a 17-pound weight loss over the past year. Laboratory testing, including a complete blood count with differential, liver function testing, amylase and lipase studies were normal. A CT scan showed a bilobed cystic lesion inferior to the body of the pancreas. An endoscopic ultrasound revealed a 5.3×3.9 cm, anechoic, bilobed cystic lesion, extrinsic to the body of the pancreas with a 1-2 mm septation and a normal pancreas. Fine-needle aspiration revealed a milky-white aspirate with negative cytology. Laboratory assessment of the cystic aspirant revealed carcinoembryonic antigen 1.7 ng/mL, amylase 148 units/L, cholesterol 300 mg/dL, and carbohydrate antigen 19-9 3 units/mL. He underwent resection of the mass, with the histopathology confirming a diagnosis of peripancreatic lymphangioma. He did well after the surgery with interval resolution of his symptoms.

Cavernous lymphangioma arising from uterine corpus

BACKGROUND

A rare case of giant uterine lymphangioma was experienced.

CASE

A 44-year-old female noted a rapidly grown abdominal tumor and its accompanied symptoms, progressive abdominal distension, lumbago, and developed leg edema. Ultrasonography made a possible diagnosis of a huge ovarian tumor; postoperative diagnosis was cavernous lymphangioma arising from the uterus.

CONCLUSION

According to the literature, lymphangioma itself is a rare tumor, and giant lymphangioma arising from uterine corpus is extremely rare. We experienced an extremely rare case of uterine lymphangioma and ultrasound tomography better imaged the tumor inside.

Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings

Benign cystic peritoneal mesothelioma (BCPM) is a rare tumor, primarily affecting young women; approximately 130 cases have been described mainly in the pathological and surgical literature. We present imaging findings of a giant BCPM in a male patient and discuss the radiological differential diagnosis with a brief review of the literature.

A clinicopathologic and immunohistochemical study of ten pancreatic lymphangiomas and a review of the literature

BACKGROUND

Pancreatic lymphangiomas are rare benign tumors, of which only a few cases have been reported in the literature. In this study, the authors present a series of primary pancreatic lymphangiomas.

METHODS

Cases of nonepithelial pancreatic cystic tumors (lymphangiomas) diagnosed between 1966 and 1994 were retrieved from the Endocrine Pathology Registry of the Armed Forces Institute of Pathology. Histologic features (in 10 cases) as well as histochemical and immunohistochemical studies (in 6 cases) were reviewed. Long term patient follow-up data were obtained in 9 cases.

RESULTS

The patients included 8 females and 2 males ages 2-61 years (mean age, 28.9 years) at initial presentation. The tumors were circumscribed and occurred predominantly (in 6 of 10 cases) in the tail of the pancreas. The multicystic, serous, or chylous fluid-filled cystic tumors ranged from 3 to 20 cm (average, 12.7 cm) in greatest dimension. Histologically, the tumors consisted of multilocular cystic spaces of various sizes, lined by endothelial cells. The stroma contained smooth muscle and mature lymphocytes. Immunohistochemistry determined the endothelial lining cells to be factor VIII-R antigen and CD31 positive (in all cases tested) but usually CD34 negative. All patients for whom follow-up data were obtained (n=9) were alive without evidence of disease an average of 7.2 years after initial diagnosis.

CONCLUSIONS

Pancreatic lymphangiomas occur predominantly in females within a wide age range. Multilocular, fluid-filled cysts, with endothelial immunoreactivity for factor VIII-R antigen and CD31, are characteristic of these tumors. Complete surgical excision of these benign tumors resulted in excellent long term prognoses for all patients studied.

CT of pancreatic neoplasms. Part II: The unusual tumors

The pancreas gives rise to a remarkable variety of neoplasms other than ductal adenocarcinoma. Although no individual type of tumor in this category is prevalent enough to qualify as common, most types are currently encountered with a frequency far greater than that in decades of the recent past. This change is largely the result of the expanded use of contemporary abdominal imaging. The unusual tumors of the pancreas vary greatly in their biologic behavior and, accordingly, in their clinical consequences and therapeutic requirements. Accurate diagnosis, therefore, can be of considerable clinical relevance. Not only is it worthwhile to distinguish one type of unusual pancreatic tumors from another, it is perhaps of even greater consequence to distinguish the unusual tumors from ordinary pancreatic adenocarcinomas. The goals of this discussion are to expand radiologic awareness of these uncommon but interesting pancreatic neoplasms and to increase familiarity with their diagnostically salient features.

Mesenteric cystic lymphangioma with myxoid degeneration: unusual CT and MR manifestations

We report an unusual case of mesenteric cystic lymphangioma presenting as a large multilocular mass with a well-enhanced solid component and a central cleft, which were were pathologically correlated to the prominent stromal myxoid degeneration interspersed with abundant capillaries and the central fibrosis, respectively. The findings of computed tomography and magnetic resonance imaging are illustrated. Recognition of the multilocular configuration of the enhanced stroma may help to make the correct preoperative diagnosis.

Hemorrhagic lymphangioma mimicking hemoperitoneum: MR imaging diagnosis

Omental cystic lymphangioma is an uncommon malformation that occurs in children. The authors report the magnetic resonance (MR) imaging findings in a case of hemorrhagic cystic abdominal lymphangioma, which clinically mimicked a recurrent hemoperitoneum. They demonstrate the superiority of MR imaging relative to computed tomography and ultrasound in diagnosing large hemorrhagic cystic masses and differentiating them from free intraperitoneal fluid with multiplanar imaging and fluid characterization. This enables precise tumor localization and extension, aiding surgical resection.