Rupture of a giant jejunal mesenteric cystic lymphangioma misdiagnosed as ovarian torsion: A case report

BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who complained of abdominal pain.The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder,ovary,and uterus.The patient underwent emergency laparotomy per-formed by gynecologists,but it was discovered that the cystic tumor originated from the jejunum.Gastrointestinal surgeons were then called in to perform a cystectomy.Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery.The patient had an uneventful postoperative recovery.CONCLUSION Mesenteric lymphangiomas can cause abdominal pain,and imaging techniques can help determine their characteristics,location,and size.Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.

Congenital Cervico-Mandibular Cystic Lymphangioma in Pediatric Surgical Setting in Guinea

Introduction: Cystic lymphangiomas are rare benign malformative tumors of the lymphatic system of obscure etiopathogenesis. The cervico-facial location remains the most common (75%). Although benign, these tumors remain potentially fatal, due to possible compression of the upper aero-digestive tract. The aim of this work is to study the epidemiological, diagnostic and therapeutic characteristics of cervico-mandibular congenital cystic lymphangiomas in the pediatric surgery department of the Donka National Hospital (HND) Conakry. Patients and methods: This is a retrospective and descriptive study of 13 files lasting 7 years from January 2015 to December 31, 2021. The files of children whose age is less than or equal to 15 years operated on cervical tumor with histological evidence of cystic lymphangioma were retained. The data were analyzed using SPSS statistical software 21 and anonymously. Results: The incidence of this study was 1.86 cases per year and a sex ratio of 0.62 in favor of girls. The average age was 8 months 19 days. In the antecedents, we only find poorly monitored pregnancies. The average size of the tumors was 11.85 cm. Cervical ultrasound and standard x-ray of the cervical mass were the only examinations performed. Total surgical excision of the cervical tumor was performed in all patients. The mass was polycystic on exploration. The histological examination of the surgical specimens was in favor of a cystic lymphangioma. The surgical consequences were simple in 11 patients (84.62%) and complicated by parietal suppuration in 2 cases (15.38%). There were no cases of recurrence after one year of follow-up. Conclusion: Cervico-mandibular cystic lymphangiomas are the most frequent locations of congenital lymphangiomas in children. Their severity is linked to the risk of compression of the aero-digestive tracts. Their diagnosis must be confirmed by the histology of the surgical specimen. Despite the therapeutic arsenal, excision of the cystic mass remains the only effective alternative in our socio-economic conditions to avoid recurrences and loss of follow-up of patients.

Retroperitoneal cystic lymphangioma in an adult:A case report and review of the literature

Lymphangiomas are rare benign cystic tumors of the lymphatic system.Retroperitoneal lymphangiomas account for 1%of all lymphangiomas,and approximately 186 cases have been reported.They may clinically present as a palpable abdominal mass and can cause diagnostic dilemmas with other retroperitoneal cystic tumors,including those arising from the liver,kidney and pancreas.This report describes the rare case of a cystic retroperitoneal lymphangioma in a 54-year-old male patient.The lymphangioma had progressed to the point of inducing clinical symptoms of abdominal distention,abdominal pain,anorexia,fever,nausea and diarrhea.Radiological imaging revealed a large multiloculated cystic abdominal mass with enhancing septations involving the upper retroperitoneum and extending into the pelvis.Surgical removal of the cyst was accomplished without incident.A benign cystic retroperitoneal lymphangioma was diagnosed on histology and confirmed with immunohistochemical stains.

Giant cystic lymphangioma originating from the lesser curvature of the stomach

Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital and acquired(traumatic)etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces.This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection.A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain,vomiting,anorexia and unintentional weight loss accompanied by rapid abdominal distension.A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process,measuring 40 cm in diameter.Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid.The process appeared to originate from the lesser omentum and the lesser curvature of the stomach.Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues.Histological analysis confirmed the diagnosis of a multicystic lymphangioma.The postoperative recovery was uneventful and the patient was discharged after 6 d.At 3-mo follow-up,the patient was in good health with no signs of recurrence.

Adult intussusception caused by cystic lymphangioma of the colon:A rare case report

We experienced a case of intussusception caused by cystic lymphangioma of the colon in a 32 years old female who was admitted to our hospital for the chief complaint of bloody stool. In the colonoscopic examination, cystic mass with stalk which had smooth mucosal surface was noted at the descending colon. Abdominal ultrasonography and computed tomography revealed left colon intussusception with a multilocular cystic tumor as a leading point. Emergent operation was performed. On the histopathologic examination, the cystically dilated spaces lined by endothelium and septated by fibrous septa were present. The pathological diagnosis was cystic lymphangioma of the colon. Although intussusception due to lymphangioma in an adult are rare, it should be taken into consideration that it is possible diagnosis.

Intra-Abdominal Cystic Lymphangioma: Report of 21 Cases

Studying in a retrospective review of 21 cases, diagnostic, therapeutic and evolutionary aspects of intra-abdominal cystic lymphangioma (CL). Methods: Between 1992 and 2014, 21 patients were operated at our institution for a CL. Clinical presentation, location, surgical management and outcome were studied. Results: There were 14 women and 7 men. All CL were diagnosed by abdominal ultrasound and/or abdominal CT scan. The most common site was the retroperitoneum (24%) followed by equally by the mesentery, the mesocolon and abdominal wall. Surgical treatment consisted of a complete resection of cyst in 20 patients. This resection required a splenectomy in one case for a splenic location and digestive resection in 2 cases. Two cases of recurrence of CL were revealed. The first case was a result of partial resection, but the second case occurred in a patient who underwent a total cystectomy. These patients were asymptomatic, so we decided to monitor them. Conclusion: CL in adult is a rare disease. The preoperative diagnostic has benefited from the contribution of imaging mainly ultrasound and CT scan, treatment consisted of surgical complete excision to prevent recurrences.

Retroperitoneal Cystic Lymphangioma: Case Report

Introduction: Retroperitoneal cystic lymphangioma is a rare benign tumor of the retroperitoneal lymphatics that usually manifests in infancy. It is worth to Report of unexpected presentation especially in Adult. Case Presentation: An adult patient with Left Lower abdominal was referred to our hospital. Abdominal ultra-sonography revealed a large, multilocular, cystic mass with an obscure margin. CT of the abdomen showed a large homogeneous mass. Laparoscopy revealed a huge retroperitoneal cystic lymphangioma confirmed by histopathology. Conclusion: Adult cyst lymphangioma is the rare benign tumor with unclear intra abdominal manifestation. In our report the retroperitoneum was the rare location of this tumor.

A case of cystic lymphangioma of the mediastinum

Cystic lymphangioma of the mediastinum (CLM) is extremely rare, usually a lot of the patients were found to have the disease by accident in adulthood.It is difficult to be diagnosed but surgery.We have received and treated a case and the diagnosis and therapy are worth discussing.

Cervicofacial Cystic Lymphangiomas and Review of the Literature: About 2 Cases at Donka National Hospital

In this retrospective study, conducted over 7 years (2009-2016) at the ENT and Head and Neck Surgery Department of the Donka National Hospital, we report 2 cases of cervicofacial cystic lymphangiomas. They were a 28-month-old girl and a 2-year-old boy. The symptomatology was noted after their birth. Dyspnea and dysphagia were found in the boy. They had a satisfactory general condition. ENT examination noted a cystic-like tumor syndrome. Imaging showed evidence of a cystic lymphangioma of the cervicofacial region. Pathological examination confirmed the diagnosis. All patients underwent exeresis cervicotomy. We found adhesion of the lymphangioma cyst to the internal jugular vein in the children. The boy presented a paralysis of the chin branch of the facial nerve after the surgery. We did not find any tumor recurrence. However, cystic cervicofacial lymphangiomas are a particular aspect of surgical pathology in children in Africa. In spite of the advent of sclerosing products, surgery remains for us the treatment of choice.

Lymphoepithelial cysts and cystic lymphangiomas: Underrecognized benign cystic lesions of the pancreas

AIM: To identify their diagnostic and prognostic clinical characteristics in a large series.METHODS: Retrospective review of clinicopathologic and imaging characteristics of patients diagnosed with lymphoepithelial cysts and cystic lymphangiomas of the pancreas at Massachusetts General Hospital.RESULTS: Twelve patients were identified between 1/1/1997 and 8/1/2007. Their median age was 55.5 years(range 19-78 years), and 6 were females. The le-sion was incidentally discovered in half of the patients.Contrast enhanced computed tomography demonstrat-ed that the cysts had thin walls, without calcifications, pancreatic duct dilation or pancreatic parenchyma inva-sion. Endoscopic ultrasound with fine needle aspiration(EUS/FNA) confirmed the diagnosis of a lymphoepithe-lial cyst in 3 patients, one of whom was spared an op-eration and continues to do well after 6 years. Eleven patients had a resection: 3 pancreaticoduodenecto-mies, 7 distal pancreatectomies, and 1 enucleation. The median size of the cysts was 3 cm(range 2-20 cm). At a median follow-up of 57 mo no recurrences or other pancreas-related conditions occurred.CONCLUSION: Lymphoepithelial cysts and cystic lymphangiomas of the pancreas can be diagnosed with a combination of contrast-enhanced computed tomog-raphy scans and EUS/FNA. If the lesion is asymptom-atic, an operation might be avoided.

Unusual Presentation of a Large Multi-Septated Cystic Hygroma: A Case Report and Comprehensive Literature Review

Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions and MRI findings of cystic hygromas in the extremities are rare. Aim: This case report aims to present a unique instance of a cystic hygroma in the left thigh. The objective is to provide detailed insights into the characteristics of this atypical presentation. Case Presentation: The case involves a 2-year-10 month-old girl with a cystic hygroma in her left thigh. The report includes a comprehensive description of the lesion’s clinical features and diagnostic evaluation, emphasizing the MRI findings to enhance understanding of this rare occurrence. Conclusion: This case report highlights the rarity of cystic hygromas outside the cervicofacial, thoracic, and abdominal regions, explicitly focusing on the occurrence in the left thigh. By presenting detailed insights into the clinical features, MRI findings, histopathological findings, and the surgical approach employed, this report contributes to the existing knowledge on this condition in atypical locations and informs future treatment strategies.

Cystic lymphangioma of the pancreas

Lymphangioma of the pancreas is an extremely rare benign tumour of lymphatic origin, with fewer than 60 published cases. Histologically, it is polycystic, with the cysts separated by thin septa and lined with endothelial cells. Though congenital, it can affect all age groups, and occurs more frequently in females. Patients usually present with epigastric pain and an associated palpable mass. Complete excision is curative, even though, depending on the tumour location, surgery may be simple or involve extensive pancreatic resection and anastomoses. The authors present a 49-year-old woman in whom a polycystic septated mass, 35 mm× 35 mm in size, was discovered by ultrasonography （US） in the body of the pancreas during investigations for epigastric pain and nausea. At surgery, a well circumscribed polycystic tumor was completely excised, with preservation of the pancreatic duct. The postoperative recovery was uneventful. Histology confirmed a microcystic lymphangioma of the pancreas. Immunohistochemistry showed cystic endothelial cells reactivity to factor Ⅷ -RA （＋＋）, CD31 （＋＋＋） and CD34 （-）. Postoperatively, abdominal pain disappeared and the patient remained symptomfree for 12 mo until now. Although extremely rare, lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of a pancreatic cystic lesion, especially in women.

Cystic Lymphangioma on the Floor of the Oral Cavity Extending to the Submandibular Region in Adult Patients

Lymphatic malformation (ML), formerly called cystic lymphangioma is a benign hamartomatous tumor of lymphatic vessels. The onset of lymphangiomas is either at birth (60% to 70%) or up to two years of age (90%) and rare in adults. These malformations can occur in any region of the body, Lymphangiomas have marked predilection for the head and neck region (50% - 70%). The most common location in the mouth is the dorsum of tongue. If the positive diagnosis is generally easy, the therapeutic management remains controversial. We report the clinical case of a 23-year-old adult patient with cystic lymphangioma on the floor of the oral cavity extending gradually to the right submandibular region. The clinically suspected tumor was thoroughly explored using tomodensitometry. The treatment consisted of complete resection by a cervicotomy with histological examination confirming the macroscopic diagnosis of cystic lymphangioma. Follow-up at 3 years showed no recurrence.

Laparoscopic segmental colectomy for colonic lymphangiomas: A definitive, minimally invasive surgical option

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.

MRI与CT检查诊断腹部囊性淋巴管瘤的作用与价值分析

目的探讨MRI、CT在诊断腹部囊性淋巴管瘤中的应用价值。方法选取2019年2月至2021年2月麻城市人民医院收治的90例疑似腹部囊性淋巴管瘤患者作为研究对象,对所有患者实施MRI检查、CT检查、手术病理检查或穿刺活检,评价不同影像学检查对腹部囊性淋巴管瘤的诊断效能。结果90例患者经手术病理检查或穿刺活检证实,64例为腹部囊性淋巴管瘤,26例为非腹部囊性淋巴管瘤。CT诊断腹部囊性淋巴管瘤的准确度、特异度、灵敏度分别为95.55%、92.30%、96.88%,MRI诊断腹部囊性淋巴管瘤的准确度、特异度、灵敏度分别为96.67%、92.30%、98.43%;CT与MRI诊断腹部囊性淋巴管瘤的准确度、特异度、灵敏度比较差异无统计学意义。腹部囊性淋巴管瘤在MRI、CT检查中有典型的影像学资料表现。不同类型腹部囊性淋巴管瘤在MRI、CT检查后的影像学资料表现不同。结论MRI与CT检查均可用于腹部囊性淋巴管瘤的诊断,两者诊断效能具有高度一致性,不同医院应结合实际情况及患者意愿灵活选择检查方法,提高腹部囊性淋巴管瘤的诊断准确度。

以颈部肿块首发男性甲状腺乳头状癌误诊分析

目的 分析男性甲状腺乳头状癌(papillary thyroid carcinoma, PTC)误诊的原因及防范误诊措施。方法 回顾性分析2018年2月-2022年3月收治2例曾误诊的男性PTC的临床资料。结果 2例均因发现颈部肿块就诊,经颈部彩超、CT检查考虑为囊性淋巴管瘤、鳃裂囊肿各1例。2例经手术病理检查确诊为PTC,其中1例伴颈部淋巴结转移。误诊时间分别为22、14 d。2例确诊后均行甲状腺全切术及颈部淋巴结清扫术治疗,术后分别随访1年、半年,预后较好,均未见复发。结论 男性PTC临床表现无特异性,应加强对该病的认识,提高警惕性,仔细查体,认真鉴别诊断,及早行甲状腺超声、CT检查甚至病理检查,以提高本病术前诊断率。

Pancreatic lymphangioma:two case reports from an institutional experience with a rare entity and review of literature

Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic lesions.As such,pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised lesion.We present 2 cases of pancreatic lymphangioma,determine its prevalence at our institution and perform a detailed review of published literature since 2010.Case 1 is a 36-year-old male and case 2 is a 35-year-old female,both of which presented with abdominal pain.These were the only cases of pancreatic lymphangiomas reported at our institution since 2010.We reviewed 69 cases of pancreatic lymphangiomas from 52 publications.It affects predominantly females with a median age of 43 and such patients typically present with abdominal pain(58.8%)or are asymptomatic(27.9%).The median size is 8.6 cm,the most common location is the head of pancreas and the most common imaging finding is that of a multilocular cyst.Majority of patients underwent surgical resection(69.6%).Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid,elevated fluid triglyceride levels(15/16 cases)and numerous lymphocytes on cytology.The majority of patients with elevated fluid triglyceride levels(13/15 cases)were managed conservatively.Pancreatic lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical,radiological,biochemical and cytological features,allowing greater confidence in the selection of patients who can be managed conservatively.

胎儿颈部囊性包块的MRI诊断与鉴别

目的:总结分析28例胎儿颈部囊性包块的MRI特点,提高产前MRI诊断水平。方法:搜集经产前超声检查发现的28例胎儿颈部囊性病变,于3d内行胎儿颈部MRI检查,回顾性分析28例病例的临床及影像资料。结果:28例胎儿颈部囊性包块中16例位于左侧,3例位于颈部正中,9例位于右侧;其中6例跨越中线;11例囊内有分隔。28例胎儿颈部囊性包块内信号特点均表现为T1WI低信号、T2WI高信号,2例在新生儿期T1WI信号不同程度增高,内可见气液平面和液液平面。经手术或引产后病理证实确诊为淋巴管瘤15例(其中1例位于颈前体积较小的淋巴管瘤出生后自然消退),腮裂囊肿8例,甲状舌管囊肿1例,食道闭锁4例。结论:胎儿MRI检查能够弥补胎儿超声检查的不足,获得更多产前诊断信息。

肝囊型包虫病与单纯性肝囊肿患者肝脏MRI表现分析

目的 探讨磁共振扩散加权成像(MR DWI)用于鉴别诊断肝囊型包虫病与单纯性肝囊肿的价值。方法 2019年7月~2022年7月我院收治的肝囊型包虫病42例和单纯性肝囊肿34例,均接受MR DWI检测病灶和肝脏表观扩散系数(ADC)。取b值=500 s/mm^(2)和1000 s/mm^(2)时病灶和肝脏ADC值。应用受试者工作特征曲线(ROC)分析ADC值诊断肝囊型包虫病的效能,采用Kappa分析不同b值下病灶ADC值联合诊断肝囊型包虫病与临床诊断结果的一致性。结果 当b值为500 s/mm^(2)时,肝包虫病病灶ADC为(3.1±0.7),当b值为1000 s/mm^(2)时,肝包虫病病灶ADC为(2.4±0.6),显著低于肝囊肿【分别为(3.6±0.9)和(3.2±0.9),P<0.05】;经ROC分析发现,当b值=500 s/mm^(2)时,病灶ADC≤3.235为诊断肝囊型包虫病的最佳截断点,其曲线下面积(AUC)为0.743,95%可信区间(CI)为0.631~0.855,诊断的敏感度为0.706,特异性为0.690(P<0.05),当b值=1000 s/mm^(2)时,病灶ADC≤2.650为诊断肝囊型包虫病的最佳截断点,其AUC为0.857,95%CI为0.771~0.944,敏感度为0.824,特异性为0.762(P<0.05);以达到两种b值下病灶ADC值诊断的截断点为诊断肝包虫病的依据,经一致性分析发现,两种ADC值联合诊断肝囊型包虫病的敏感度为0.929,特异性为0.971,准确率为0.947,阳性预测值为0.975,阴性预测值为0.917,且一致性较高(Kappa=0.894)。结论 相对于单纯性肝囊肿,肝囊型包虫病病灶ADC值显著降低,应用MR DWI检测ADC有助于简易地诊断肝包虫病。

胰尾部囊状水瘤1例

1病例资料患者女性,52岁,因体检发现腹腔肿物8天而就诊,外院腹部超声示左肾与脾脏之间大小约14×10×6cm囊性包块,形态欠规则,边界清楚,内可见较多分隔。后患者寻求进一步诊治就诊于我院,门诊以“腹腔肿物”收住院。腹部查体:未见任何异常。既往“高血压病”史3年,最高180/100mmHg,口服“尼群地平片1片/日”血压控制可。实验室检查:癌胚抗原、甲胎蛋白、铁蛋白和糖类抗原19-9均在正常范围。