Cystic lymphangioma is a rare congenital malformation of the lymphatic system. While the lesion is frequent in the neck and axilla, abdominal localization is rare and difficult to diagnose preoperatively. We report a case each of giant cystic lymphangioma of the pancreas and of the colon.
A 28-year-old man with no past history of disease, including gallbladder lithiasis and acute/chronic pancreatitis, or abdominal trauma, presenting with severe abdominal pain and a mass in the left hypochondrium was referred to our institution for detailed examination. Abdominal ultrasonography showed the presence of a large, septated, multilocular anechoic mass in the tail of the pancreas. Based on the results of further examination, a serous cystic tumor or lymphangioma of the pancreas was suspected, and tumor excision with distal pancreatectomy while preserving the spleen was performed.
A 59-year-old woman with a history of hypertension who presented with abdominal pain and a mass on the right side of the abdomen was admitted to our institution. Abdominal ultrasonography showed the presence of a large, septated, multilocular anechoic mass located behind the ascending colon. Based on the results of further examination, lymphangioma originating from the retroperitoneum was suspected, and tumor excision with colectomy was perfomed. Microscopical finding revealed the tumor originating from the ascending colon.
In both cases, immunohistochemical investigation of the resected tumor specimens showed positivity for D2-40 and negativity for cytokeratin. The postoperative course in both patients was uneventful and the patients still remain alive.