Clinical manifestation and treatment of small intestinal lymphangioma: A single center analysis of 15 cases

Abstract

BackgroundSmall intestinal lymphangioma is a very rare benign lesion. Thus far, the literature on small intestinal lymphangioma has mainly involved case reports. The present study retrospectively examined the clinical features of patients with a pathological diagnosis of small intestinal lymphangioma.Materials and methodsFrom January 2010 to January 2021, 15 patients were pathologically diagnosed with small intestinal lymphangioma. The age, gender, clinical manifestation, computed tomography (CT) findings, endoscopic findings, localization of the lesion, treatment method, complications, and follow-up were retrospectively analyzed.ResultsMost of the patients had no symptoms, and those with symptoms had melena or abdominal pain. Lymphangioma was located in the duodenum in nine cases (60.0%), jejunum in two (13.3%), jejunal-ileal junction with mesentery involvement in one (6.7%) and ileum in three (20.0%). Three cases (20.0%) had multiple lesions, and the other 12 (80.0%) had single lesions. The median size of the lesions was 0.8 cm. Thirteen cases were found by endoscopy, and nine cases of them had white-colored spots on the surface. Ten cases (66.7%) underwent endoscopic treatment, three (20.0%) underwent surgical treatment, and two (13.3%) were followed up. Postoperative acute pancreatitis developed in one patient after endoscopic resection of duodenal papillary lymphangioma; postoperative abdominal bleeding occurred in one patient with jejunal lymphangioma who underwent partial small bowel resection.ConclusionSmall intestinal lymphangioma is extremely rare, and its clinical manifestations are non-specific. Endoscopy is of great value in the diagnosis of small intestinal lymphangioma. Depending on the clinical manifestations, the size, location and scope of the lesions, follow-up, endoscopic treatment and surgery can be selected.

Intermittent melena and refractory anemia due to jejunal cavernous lymphangioma: A case report

“…Lymphangioma can arise from malformations of the lymphatic system during embryonic development or from acquired factors such as trauma, surgery, inflammation, and parasitic infections[ 8 ]. Lymphangioma can be histopathologically classified into three subtypes: Cavernous, capillary, and cystic lymphangioma, which may manifest in any part of the body[ 9 , 10 ].…”

“…Intestinal lymphangioma is extremely rare in adults. A mere total of 52 cases have been reported in the English literature since 1961[ 2 , 3 , 6 , 8 , 13 - 23 ].…”

“…The use of CT, magnetic resonance imaging (MRI), and ultrasound, although lacking specificity and having limited accuracy, is advantageous for facilitating the detection of lesions and differential diagnosis. On CT, intestinal lymphangiomas are nonenhanced, well-demarcated and low-density oval masses beneath the submucous membrane[ 8 ]. CT scans may yield inconclusive results, with a positive rate of 39.1%[ 3 ].…”

Mesenteric Cystic Lymphangioma, an acute presentation in a 9-year-old child

“…Presentation, whether a cyst or a lymphangioma, varies and depends on the anatomic site and size. It can range from being asymptomatic and detected incidentally to being life-threatening [9] . Unspecific abdominal symptoms such as nausea, vomiting, digestive disorders, melena, palpable abdominal mass, increasing abdominal girth, or pseudo-ascites have been reported [4 , 5] .…”