Small bowel lymphangioma

Laparoscopic Resection for Lymphangioma Originating From Small Intestine: A Case Report

“…LA in the small intestine is reported to account for approximately 1.4% to 2.4 % of all small intestinal tumors by Worapop et al, 2 but considering that LA originating from the small intestinal mesentery is included in their report, LA originating from the small intestinal wall is an extremely rare finding. As far as we searched in PubMed, there has been only 16 reports, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] including our case on lymphangiomas in the small intestinal wall (Table 1).…”

“…8 Of the 16 cases in Table 1, 13 cases underwent surgery, all of which were resected without preoperative diagnosis of LA. Only 2 cases (cases 6 7 and 13 14 ) were left unresected, because in 12 Bucciero 2015 28 yr Male Melena Endoscopy, CT Jejunum Surgery (not available) 12 13 Iwaya 2018 70 yr Male Tarry stool DBE Jejunum (120 cm from Treitz ligament) Surgery (Lap) 13 14 Costa 2019 56 yr Female None DBE Proximal jejunum Biopsy 14 15 Giuliani case 6, the patient was asymptomatic, and in case 13, hemostasis was successfully achieved with an endoscopic procedure instead of surgical resection. The location of tumors is also described in Table 1.…”

Atypical ileocaecal valve polyp at endoscopy: a rare case of intestinal lymphangioma in an adult woman

“…Endoscopically, intestinal lymphangioma appears as a sessile or semi‐pedunculated mass with smooth overlying mucosa and variable cystic lymphatic dilatation 2,5 . It is white‐yellow in colour with granular white spots across the mucosal surface, and is often associated with drainage of milky lymphatic fluid following biopsy 6,7 . Differential diagnoses for these appearances endoscopically includes lymphangiectasia, haemangiolymphangioma, gastrointestinal stromal tumour, malignant lymphoma, plasmacytoma and parasitic disease 1,3,4 .…”

“…Despite lacking malignant potential, definitive management for intestinal lymphangioma is surgical excision for the reasons aforementioned. Close surveillance with interval endoscopy for those lesions not amenable to resection endoscopically, as in this case, may be considered a suitable alternative if the macroscopic appearances are benign, and the patient wishes to avoid bowel resection if no other evidence of associated malignancy has been identified 6 . Preoperative radiologic assessment, often with CT but also ultrasonography, is performed to determine the extent of tissue involvement and exclude concurrent intraabdominal pathology.…”

“…2,5 It is white-yellow in colour with granular white spots across the mucosal surface, and is often associated with drainage of milky lymphatic fluid following biopsy. 6,7 Differential diagnoses for these appearances endoscopically includes lymphangiectasia, haemangiolymphangioma, gastrointestinal stromal tumour, malignant lymphoma, plasmacytoma and parasitic disease. 1,3,4 Clinical diagnosis is confirmed on histological analysis, which importantly must distinguish primary lymphangioma from obstructive lymphangiectasia associated with underlying malignancy, as this cannot be determined solely by endoscopy.…”