A case of multiple lymphangiomas of the colon suggesting colonic lymphangiomatosis

Lymphangiomatosis of the sigmoid colon - a rare cause of lower gastrointestinal bleeding: A case report and review of the literature

The present study reports the case of a 79-year-old Chinese man who presented to The First Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) for the treatment of lower gastrointestinal bleeding. Multiple cystic masses in the sigmoid colon were observed with colonoscopy, and through endoscopic ultrasound (EUS), these cystic masses were confirmed to be echo-free and to exhibit septal walls in the submucosal layer; in consequence, lymphangiomatosis of the sigmoid colon was diagnosed. Considering the repeated bleeding, laparoscopy-assisted partial sigmoid colon resection was performed. The excised specimens were multiple vesicular and soft masses of ~1 cm in diameter, which were located in the submucosal layer and were surrounded by flat endothelial cells. Immunohistochemistry revealed that the specimens were positive for the specific lymphatic endothelial marker D2-40. The pathological diagnosis was consistent with the EUS findings. In the 2-year follow-up after the operation, no bleeding or other complications were noticed.

Colonic lymphangiomatosis resolved after excisional biopsy

Lymphangioma is an uncommon malformation of the lymphatic system that involves a benign proliferation of the lymphatics, with no established treatment method. Multiple colonic lymphangioma, or colonic lymphangiomatosis, is an extremely rare condition. We report a case of colonic lymphangiomatosis that was detected during a colonoscopic examination conducted as part of a general health check-up. The lesion completely resolved after excisional biopsy.

Case report - An acute presentation of lymphangiomatosis

INTRODUCTION

Lymphangioma is an uncommon malformation of lymphatic system. Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease.

PRESENTATION OF CASE

We report a case of colonic lymphangiomatosis presenting as recurrent right iliac fossa pain in a young female treated surgically.

DISCUSSION

Lymphangiomatosis is a rare but benign disease with a variety of presentations. There are few reported cases in the literature at present and no guidelines regarding the diagnosis or treatment of the same.

CONCLUSION

Our case demonstrates an unusual presentation of lymphangiomatosis treated surgically. Debate will remain on this rare condition.

Unilateral lymphangiomatous polyp of the palatine tonsil in a very young child: a clinicopathologic case report

Childhood lymphangiomatous polyp of the palatine tonsil is a very unusual lesion found in the head and neck. Tonsillectomy has been reported to be the curative procedure of choice for this lesion. We report a case of a very young child with unilateral lymphangiomatous polyp of the palatine tonsil.

Spontaneous resolution of multiple lymphangiomas of the colon: A case report

Lymphangioma of the colon is a relatively rare non-epithelial tumor and usually presents as a submucosal polypoid lesion. Many cases incidentally discovered are usually asymptomatic. However, they may present as abdominal pain or bleeding, and their resection is normally required. Lymphangioma itself is generally recognized as a benign tumor and no cases of malignant transformation have yet been reported, although its natural history is currently unknown. To the best of our knowledge, this study is the first to describe a case of spontaneous resolution in multiple colonic lymphangiomas without any specific treatment.

A case report with lymphangiomatosis of the colon

The incidence of lymphangiomas in the gastrointestinal tract is low, particularly in the colon and rectum, and most cases are solitary. Lymphangiomatosis of the colon are encountered infrequently with only one report in the English literature, and polypectomy was performed for the diagnosis in that case report. However, trends in the diagnosis of lymphangiomatosis of colon have been changing since the development of endoscopic ultrasonography (EUS), and this case is the first in that lymphangiomatosis of the colon was diagnosed without invasive procedures. Here we describe the case of 31-yr-old woman with lymphangiomatosis of the colon with numerous polyposis-like appearing lesions diagnosed by endoscopic ultrasonography and a colonoscopy.

An unusual presentation of primary sclerosing cholangitis

This case report describes the unusual presentation of a patient who had findings which were initially suggestive of a type IV  choledochal cyst. Her liver biopsy demonstrated biliary cirrhosis. She was treated with endoscopic retrograde cholangiopancreatography and biliary stent exchanges over one year. Her cholangiogram one year later demonstrated resolution of the biliary cystic dilation which led to her initial diagnosis, with beading and stricturing of the hepatic ducts consistent with primary sclerosing cholangitis. Liver-associated enzymes and physical findings also improved. A liver biopsy one year later demonstrated a marked improvement in hepatic fibrosis with no evidence of cirrhosis.

Colonic lymphangiomatosis associated with anemia

Lymphangioma is an uncommon malformation of lymphatic system. Multiple colonic lymphangioma named as lymphangiomatosis is considered an extremely rare disease. Although lymphangioma is a benign tumor and most colonic lymphangiomas do not cause symptoms and do not require treatment, resection of lymphangioma is necessary in the presence of symptoms such as abdominal pain, bleeding, intussusceptions. We report a case of colonic lymphangiomatosis in a man who presented with abdominal discomfort and anemia, which was diagnosed and treated with endoscopic snare polypectomy.

Diffuse neonatal abdominal lymphangiomatosis: management by limited surgical excision and sclerotherapy

Complete excision of diffuse abdominal lymphangiomatosis in the newborn is next to impossible. A 3-day-old female infant was found to have diffuse abdominal lymphangiomatosis predominantly in the left mesocolon and retroperitoneum. Initial management was by marsupialization, which was complicated by chylous ascites requiring periodic paracentesis and nutritional support. At the age of 45 days, left hemicolectomy and partial excision of the retroperitoneal cysts were performed together with intracystic injection of OK-432 into the residual cysts. The patient's progress after the second operation was satisfactory. Initial marsupialization followed by delayed partial resection together with injection of OK-432 into the residual cysts is an effective method of managing diffuse abdominal lymphangiomatosis in the newborn.