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Hattori A, Inoue H, Kurata K, Tsuboi J, Yamada R, Hamada Y, Katsurahara M, Tanaka K, Horiki N, Takei Y. Cystic lymphangioma of the hepatoduodenal ligament: a rare intra-abdominal tumor mimicking hematoma. Clin J Gastroenterol 2020; 14:212-217. [PMID: 32996113 DOI: 10.1007/s12328-020-01250-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/15/2020] [Indexed: 11/26/2022]
Abstract
A 22-year-old man was referred for upper abdominal pain. Unenhanced computed tomography (CT) revealed a lesion of heterogeneous hypoattenuation, part of which showed slightly high-density in the porta hepatis. On magnetic resonance imaging (MRI), T1-weighted images showed a multiloculated hyperintense mass and part of the mass was hyperintense in T2-weighted images. Abdominal ultrasonography showed a 40 mm multilocular mass with septa, containing solid and small cystic components. In sonazoid-enhanced ultrasonography, the septa were enhanced but the solid components were not. Because of the location of tumor and the findings of CT/MRI, we suspected the lesion as hematoma of the liver. We could not exclude neoplastic disease, such as biliary cystadenoma or cystadenocarcinoma of the liver, so surgical resection was performed. The mass was a multilocular cyst arising from the hepatoduodenal ligament. Pathological examination revealed aggregation of lymph vessels and endothelial-like cells with no atypia, which were positive for the specific markers D2-40 and CD31. The histological diagnosis was abdominal lymphangioma. Intra-abdominal lymphangiomas, which originate from the hepatoduodenal ligament, are extremely rare, benign tumors. We are mindful that lymphangioma should be considered in the differential diagnosis of tumors in the abdominal cavity, mimicking a hematoma of the liver and with a cystic appearance.
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Affiliation(s)
- Aiji Hattori
- Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Hiroyuki Inoue
- Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kazunari Kurata
- Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Junya Tsuboi
- Department of Endoscopy, Mie University Hospital, Tsu, Japan
| | - Reiko Yamada
- Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yasuhiko Hamada
- Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | | | - Kyosuke Tanaka
- Department of Endoscopy, Mie University Hospital, Tsu, Japan
| | - Noriyuki Horiki
- Department of Endoscopy, Mie University Hospital, Tsu, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
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