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Wu CH, Lu CH. Case report: Omental lymphangioma mimicking gastric cystic tumor. Radiol Case Rep 2021; 17:212-215. [PMID: 34824652 PMCID: PMC8605189 DOI: 10.1016/j.radcr.2021.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
Omental lymphangioma is a rare pathology presented in the abdomen, and it can mimic several clinical conditions. Owing to its variable signs and symptoms, making a correct diagnosis by clinicians may be difficult. Surgical excision is the gold standard treatment. In this article, we report a case who presented with nonspecific abdominal complaints, and underwent surgery. Final pathologic diagnosis revealed omental cystic lymphangioma.
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Affiliation(s)
- Chia-Hui Wu
- Department of Medical Imaging, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City, 80756, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City, 80708, Taiwan
| | - Chia-Hsin Lu
- Department of Medical Imaging, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City, 80756, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City, 80708, Taiwan.,Department of Medical Imaging, Kaohsiung Municipal Ta-Tung Hospital, No.68, Jhonghua 3rd Rd, Cianjin District, Kaohsiung City 80145, Taiwan
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2
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Tuan NA, Van Du N, Van Hiep P. Giant cystic lymphangioma of right mesocolon: A case report. Int J Surg Case Rep 2021; 86:106326. [PMID: 34481132 PMCID: PMC8416641 DOI: 10.1016/j.ijscr.2021.106326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/22/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Cystic lymphangiomas are rare benign tumors of the lymph vessels and are usually found in children. However, abdominal cystic lymphangioma in mesocolon is extremely rare in adult patients. Presentation of case We reported a 15-year-old female with giant cystic lymphangioma of the right mesocolon. On examination, only abdominal pain was confirmed. Abdominal computed tomography (CT) showed a large multiseptated cystic mass. The patient underwent a total right mesocolic excision with the lesion. The patient recovered well on postoperative follow-up and was discharged on the fifth day. No evidence of recurrence had also been found in three months follow-up period. Discussion The diagnosis of intra-abdominal cystic lymphoma is often dismissed because the clinical symptoms are nonspecific. It is easy confusion because the ultrasound and CT scan images are relatively similar to the mesenteric and omental cysts. Sclerosing therapies may cause long-term consequences such as local recurrences with a very high proportion. Complete resection, including resection of the involved organs, is necessary. With tumors surrounding the colon, surgeons should consider performing removal block colon-lesion. Conclusion Complete tumor removal is the optimal choice for the management of intra-abdominal cystic lymphangioma. However, incomplete resection may lead to local recurrence. Intra-abdominal cystic lymphangiomas are rare benign tumors. The most common location in mesenteric small bowel, in mesocolon is extremely rare. Complete tumor removal is optimal choice for lymphangioma
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Affiliation(s)
- Nguyen Anh Tuan
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam
| | - Nguyen Van Du
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam.
| | - Pham Van Hiep
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam
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Liedtke KR, Käding C, Döring P, Bekeschus S, Glitsch AS. A case of giant retroperitoneal lymphangioma and IgG4-positive fibrosis: Causality or coincidence? SAGE Open Med Case Rep 2021; 9:2050313X211016993. [PMID: 34094565 PMCID: PMC8141978 DOI: 10.1177/2050313x211016993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
Several chronic inflammatory diseases have been found to be a subtype of IgG4-related disease, all of which have a typical clinical and histological change, which is based in particular on an overexpression of IgG4 and subsequent fibrosis. At least a part of the retroperitoneal fibrosis, which was originally classified as idiopathic, seems to be assigned to IgG4-related disease. Lymphangiomas are benign, cystic tumors that rarely occur in adults. However, there is no firm association with IgG4-related disease described in the literature to date. This report is about a patient suffering from acute renal failure due to a giant retroperitoneal cyst. Surgical resection remains incomplete in the iliac vessel area due to severe fibrosis and histology revealed features of both lymphangioma and IgG4+ fibrosis. The case description is followed by a brief overview of IgG4-related disease and a consideration of whether lymphangiomas might be assigned to this topic.
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Affiliation(s)
- Kim Rouven Liedtke
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany.,Department of Trauma and Orthopedic Surgery, Experimental Trauma Surgery, University Medical Center Schleswig-Holstein
| | - Christoph Käding
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany.,Department of Urology, Greifswald University Medical Centre, Greifswald, Germany
| | - Paula Döring
- Institute of Pathology, Greifswald University Medical Centre, Greifswald, Germany
| | - Sander Bekeschus
- Centre for Innovation Competence (ZIK) plasmatis, Leibniz Institute for Plasma Science and Technology (INP Greifswald), Greifswald, Germany
| | - Anne Susann Glitsch
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany
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Joret MO, Nanayakkara A, Kulasegaran S, Martin R. A case of cystic lymphatic malformation mimicking acute appendicitis in an adult patient: a rare diagnostic pitfall. BMJ Case Rep 2021; 14:14/3/e239509. [PMID: 33692052 PMCID: PMC7949445 DOI: 10.1136/bcr-2020-239509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abdominal cystic lymphatic malformations are rare pathological entities of uncertain aetiology that usually present in early childhood with indolent abdominal distention. We report the case of a 17-year-old man who presented to our hospital with acute right lower quadrant pain, nausea and anorexia. His blood tests revealed a raised white cell count and elevated inflammatory markers. Clinical examination revealed signs of localised right lower quadrant peritonism. A diagnosis of clinical appendicitis was made, and in keeping with local management protocols, the patient proceeded to theatre for a diagnostic laparoscopy without radiological investigations. Operative findings yielded a normal appendix and a large abdominal cystic malformation. This article highlights the need to keep a broad differential diagnosis when performing surgery on patients with clinically presumed appendicitis and the importance of radiological investigations in clinical decision-making, we also review abdominal cystic lymphatic malformations as a rare diagnostic pitfall.
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Affiliation(s)
- Maximilian Olavi Joret
- Department of General Surgery, Waitemata District Health Board, Takapuna, New Zealand .,Department of General Surgery, Taranaki District Health Board, New Plymouth, New Zealand
| | - Asanga Nanayakkara
- Department of General Surgery, Waitemata District Health Board, Takapuna, New Zealand
| | - Suheelan Kulasegaran
- Department of General Surgery, Waitemata District Health Board, Takapuna, New Zealand
| | - Richard Martin
- Department of General Surgery, Waitemata District Health Board, Takapuna, New Zealand
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5
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Lu G, Li H, Li Y. Lymphangiomatosis of the sigmoid colon - a rare cause of lower gastrointestinal bleeding: A case report and review of the literature. Oncol Lett 2016; 13:339-341. [PMID: 28123564 DOI: 10.3892/ol.2016.5399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/20/2016] [Indexed: 12/29/2022] Open
Abstract
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.
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Affiliation(s)
- Guifang Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Hongxia Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Yuanyuan Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
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Zhuo CH, Shi DB, Ying MG, Cheng YF, Wang YW, Zhang WM, Cai SJ, Li XX. Laparoscopic segmental colectomy for colonic lymphangiomas: A definitive, minimally invasive surgical option. World J Gastroenterol 2014; 20:8745-8750. [PMID: 25024636 PMCID: PMC4093731 DOI: 10.3748/wjg.v20.i26.8745] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 01/29/2014] [Accepted: 03/10/2014] [Indexed: 02/06/2023] Open
Abstract
Colonic lymphangioma is an unusual benign malformation. We herein describe two cases. A 36-year-old woman was admitted with one year of intermittent abdominal pain; colonoscopy, abdominopelvic computed tomography and endoscopic ultrasonography (EUS) revealed enlarged cystic masses at the ascending colon. In another 40-year-old man, colonoscopy and EUS revealed an asymptomatic lobulated cystic mass with four small sessile polyps at the sigmoid colon. Both patients underwent laparoscopic segmental colectomy. Both masses were histologically confirmed as cystic lymphangiomas, and the patients were discharged without complications. The management of colonic lymphangioma depends on the individual situation; close surveillance or endoscopic therapy may be appropriate for asymptomatic lesions smaller than 2.5 cm in diameter. Surgical intervention can be considered for larger lesions or in patients who develop complication risks. Laparoscopic segmental colon resection may be recommended to excise relatively large submucosal lesions because it is a definitive, minimally invasive intervention with a fast postoperative recovery.
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7
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Maqueda Merino A, Sardón Ramos JD, Vitores Lopez JM, Angulo Revilla I, Gastón Moreno A. [Mesenteric polycystic lymphangioma. A rare cause of acute surgical abdomen]. An Pediatr (Barc) 2014; 81:59-61. [PMID: 24439486 DOI: 10.1016/j.anpedi.2013.10.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 10/23/2013] [Indexed: 02/07/2023] Open
Affiliation(s)
- A Maqueda Merino
- Servicio de Cirugía General, Hospital Universitario de Álava-Txagorritxu, Vitoria-Gasteiz, Álava, España.
| | - J D Sardón Ramos
- Servicio de Cirugía General, Hospital Universitario de Álava-Txagorritxu, Vitoria-Gasteiz, Álava, España; Unidad Docente de Medicina de Vitoria, Universidad del País Vasco (UPV/EHU), Vitoria-Gasteiz, Álava, España
| | - J M Vitores Lopez
- Servicio de Cirugía General, Hospital Universitario de Álava-Txagorritxu, Vitoria-Gasteiz, Álava, España
| | - I Angulo Revilla
- Servicio de Cirugía General, Hospital Universitario de Álava-Txagorritxu, Vitoria-Gasteiz, Álava, España
| | - A Gastón Moreno
- Servicio de Cirugía General, Hospital Universitario de Álava-Txagorritxu, Vitoria-Gasteiz, Álava, España
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Li X, Shang P, Jia G, Miao J. Lymphangioma of the hepatoduodenal ligament. SURGICAL PRACTICE 2013. [DOI: 10.1111/j.1744-1633.2012.00633.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Xiaowu Li
- Department of General Surgery; The 251st Hospital of The People's Liberation Army; Zhangjiakou; China
| | - Peizhong Shang
- Department of General Surgery; The 251st Hospital of The People's Liberation Army; Zhangjiakou; China
| | - Guohong Jia
- Department of General Surgery; The 251st Hospital of The People's Liberation Army; Zhangjiakou; China
| | - Jianjun Miao
- Department of General Surgery; The 251st Hospital of The People's Liberation Army; Zhangjiakou; China
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Gureş N, Gurluler E, Alim A, Berber I, Gurkan A. Cystic pancreatic lymphangioma. Rare Tumors 2012; 4:e27. [PMID: 22826784 PMCID: PMC3401155 DOI: 10.4081/rt.2012.e27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 03/16/2012] [Accepted: 04/22/2012] [Indexed: 12/16/2022] Open
Abstract
Lymphangioma of the pancreas is a rare benign tumor of lymphatic origin. Retroperitoneal lymphangiomas account for 1% of all lymphangiomas. Herein, we report a case of cystic pancreatic lymphangioma diagnosed in 34 year-old female patient who was hospitalized for a slight pain in the epigastrium and vomiting. Radiological imaging revealed a large multiloculated cystic abdominal mass with enhancing septations involving the upper retroperitoneum. During the laparoscopic surgery, a well circumscribed polycystic tumor was completely excised preserving the pancreatic duct. The patient made a complete recovery and is disease-free 12 months postoperatively.
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Affiliation(s)
- Nazim Gureş
- Acibadem University, International Hospital General Surgery Department, Istanbul, Turkey
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Lee JM, Chung WC, Lee KM, Paik CN, Kim YJ, Lee BI, Cho YS, Choi HJ. Spontaneous resolution of multiple lymphangiomas of the colon: A case report. World J Gastroenterol 2011; 17:1515-8. [PMID: 21472113 PMCID: PMC3070028 DOI: 10.3748/wjg.v17.i11.1515] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 01/10/2011] [Accepted: 01/17/2011] [Indexed: 02/06/2023] Open
Abstract
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.
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