Hemorrhagic giant cystic lymphangioma of the liver in an adult female

Abstract

An 18-year-old woman who presented with epigastric pain was diagnosed with rupture of a hepatic tumor and transported to our hospital. Contrast-enhanced computed tomography revealed a 13-cm, low-density giant mass in the left hepatic lobe and high-density ascites, indicating abdominal bleeding from the liver tumor. The patient underwent emergent celiac angiography, and the left hepatic artery, which was believed to feed the tumor, was embolized. After the patient's condition stabilized, she underwent left hepatic lobectomy. In addition, the enlarged lymph nodes of the hepatoduodenal ligament were dissected. On microscopic examination, immunohistochemical staining revealed that both the liver cyst and the enlarged lymph node were positive for the endothelial marker CD31 and lymphangial marker D2-40. The patient was pathologically diagnosed with cystic lymphangioma of the liver. She has now been followed up for almost 4 years after surgery without any sign of recurrence.

Cystic liver lesions: a pictorial review

“…The hepatic lymphatic malformations produce varying signals in T1- and T2-weighted sequences, depending on the quantity of fat and fluid components [ 30 ]. Lympho-MR sequences can show dilated lymph duct surrounding the lesion, thereby supporting the diagnosis of HLM [ 25 , 28 ]. Finally, hepatic lymphatic malformations can spontaneously disappear (Fig.…”

Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review

“…The morphology was enough to make the diagnosis for most cases[ 13 , 31 ]. Certainly, lymphatic marker, D2-40 (podoplanin), further confirmed the identification of the disease[ 1 , 19 , 32 ]. In addition, endothelial markers, including von Willebrand factor, CD31, and CD34 and two lymphatic markers, LYVE-1 and Prox-1, are recommended through immunohistochemistry staining when it is difficult to distinguish lymphatic vessels from blood vessels[ 1 ].…”

“…Based on the reviewed literature (Table 1 ), hepatic lymphangioma could be presented at any age from newborns to the elderly (average age is 30 years)[ 19 , 20 ]. In our case, the patient was a 50-year-old female.…”

Extensive solitary lymphatic malformation of the liver in a child: a case report and literature review

“…An extensive review of the literature identified 23 cases of solitary hepatic lymphatic malformations from 1994 to 2020 (13 males and 10 females), with an age range from 22 days to 75 years [ 15 , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] ]. According to our review, the management of symptomatic LMs of the liver is still predominantly based on surgical resection [ 15 , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , 38 , 40 , [43] , [44] , [45] , [46] , [47] , [48] , [49] ]. This can be explained by the fact that the cases described concerned LMs with well-defined profiles and sufficiently distant from vascular or nerve structures, for which surgical approach could guarantee a complete resection and important neurovascular structures sparing.…”