Cystic lymphangioma of pancreas

Abstract

Rationale:Lymphangiomas are benign lymphatic malformations that mostly occur in the neck and axillary regions. Abdominal lymphangioma is a rare type of this tumor, and pancreatic lymphangioma accounts for less than 1% of all lymphangiomas. In this report, we firstly reveal the application of ultrasound-guided puncture drainage combined with cell morphological examination for the diagnosis of pancreatic lymphangioma.Patient concerns:A 35-year-old male patient was admitted to our hospital with recurrent abdominal pain and general weakness for 1 week. From abdominal ultrasound (US) showed that a large cystic lesion occupied the abdomen, about 30.0cm×25.0cm, leading to suspicion of lymphatic cyst. Computed tomography (CT) was performed for further diagnosis and staging.Diagnoses:According to pathological findings in combination with immunohistochemical features, pancreatic lymphangioma was made.Interventions:To relieve symptoms of discomfort in the patient, distal pancreatectomy and splenectomy was carried out 1 week after the CT scan.Outcomes:The patient recovered to normal status within 19 days after surgery.Lessons:The abdominal cystic lymphangiomas are difficult to be differential diagnosed from other cystic lesions. And the origin of the tumor is also hard to be detected before operation. We should combine image and pathological examination to clarify a diagnosis. Although lymphangiomas are benign tumours, they can encroach on adjacent organs and grow to an enormous size and that, resection of these invaded organs may be required for a complete excision.

Pancreatic Lymphangioma: A Case Report and Review of Literature

“…Different surgical choices may be considered, like simple cyst excision, total pancreatic resection, (Whipple procedure or distal pancreatectomy), which depends on the size and morphology of the cysts [14]. Enbloc resection of the pancreatic lymphangioma is the treatment of choice, which was done in the present case.…”

“…Moreover, the aspirated fluid from mucinous cyst will show mucin-producing columnar epithelial cells in varying amounts, arranged in papillae, clusters, or singles, these cells may or may not show cytological atypia. pancreatic Cystic carcinomas characteristically exhibit cytologically and morphologically malignant cells arranged in clusters, acinar or papillary patterns [8,13,14] A definitive diagnosis is made on histopathological examination. Grossly cystic lymphangiomas are typically soft multilobulated masses containing serosanguinous or serous fluid.…”

Linfangioma Quístico del Páncreas. Un Tumor poco Frecuente

“…En relación al tratamiento, considerando la localización de la lesión, el tamaño del quiste y su relación con estructuras anatómicas anexas como el bazo, estómago y duodeno, la resección quirúrgica es el único método eficaz, por esta razón, se han realizado diferentes técnicas quirúrgicas desde la resección solitaria del quiste hasta pancreatoduodectomías, donde la característica primordial de estas es la escisión completa del quiste, ya que la resección parcial o solamente el drenaje del líquido quístico se asocia a un 50% de recidiva (Chen et al, 2018). Por esta razón, la resección en bloque con márgenes negativos es curativa; sin embargo, el tratamiento de los LQP asintomáticos aún es controvertido (Santes & Chan, 2016).…”

“…Aparte de sus localizaciones en tejido neural y ocular, se pueden desarrollar en cualquier órgano, de tal modo que se estima que el 95 % de los linfangiomas ocurren en cuello y regiones axilares, y el 5 % restante en el abdomen (mesenterio, retroperitoneo, vísceras) y el tórax (pulmón y mediastino) (Karajgikar & Deshmukh, 2019). Los linfangiomas quísticos del páncreas (LQP), son lesiones excepcionales, estimándose que representan el 1 % de los linfangiomas de localización abdominal y el 0,2 % de todas las lesiones pancreáticas (Fujii et al, 2018;Chen et al, 2018;Bal et al, 2021;Almeida et al, 2022;Assefa et al, 2023). Desde su primer reporte, realizado por Koch en 1913, se han publicado alrededor de 140 casos en la literatura mundial (Karajgikar & Deshmukh, 2019;Bal et al, 2021;Ray et al, 2021).…”