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Chin CC, Shiau J, Luo CW, Hou MF. Lymphangioma of small bowel in adults: A rare cause of abdominal symptoms. Asian J Surg 2023; 46:863-867. [PMID: 36328839 DOI: 10.1016/j.asjsur.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/12/2021] [Accepted: 09/06/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Lymphangioma is unusual malformation of the lymphatic system and rarely occurred in adults below diaphragm. Lymphangioma in small intestine sometimes caused unspecific symptoms and even bleeding, however, this area was most difficult for endoscopic examination and worth investigation. METHODS From 1999 to 2019, we retrospectively collected eighteen adult patients with the pathological diagnosis of lymphangioma from duodenum to terminal ileum. The clinical symptoms, origin site, predisposing factor, pre-operative image surveillance, surgical intervention, histopathological findings, follow-up period, and outcome were reviewed and analyzed. RESULTS The mean age of diagnosis was 50.11 years old with female predominance. The most common symptoms were abdominal pain (77.78%), palpable mass (27.78%) and intestinal bleeding (16.67%). With the different gross and microscopic findings, the adult intestinal lymphangioma could be classified as "simple", "polyposis", and "cystic cavernous". CONCLUSION Intestinal lymphangioma in adults is a rare cause of abdominal discomfort but should be listed in differential diagnosis during daily practice. The morphology and classification may be different from pediatric group, and more large-scale studies are need for thorough investigation.
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Affiliation(s)
- Chih-Ching Chin
- Graduate Institute of Biotechnolgy and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan; Department of Pathology, E-DA Hospital, Kaohsiung, Taiwan
| | - Junping Shiau
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chi-Wen Luo
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Feng Hou
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Wang ZZ, Shen LY, Zhou JJ, Tang JL, Ye LP, Shen CB, Li SW, Zhou XB. Clinical manifestation and treatment of small intestinal lymphangioma: A single center analysis of 15 cases. Front Med (Lausanne) 2022; 9:975698. [PMID: 36213633 PMCID: PMC9537564 DOI: 10.3389/fmed.2022.975698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background Small 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 methods From 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. Results Most 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. Conclusion Small 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.
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Affiliation(s)
- Zhen-zhen Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Ling-yan Shen
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jing-jing Zhou
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jia-li Tang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Li-ping Ye
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chen-bo Shen
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Shao-wei Li
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
- Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
- *Correspondence: Shao-wei Li,
| | - Xian-bin Zhou
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
- Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
- Xian-bin Zhou,
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Liu X, Wu X, Tuo B, Wu H. Ectopic pancreas appearing as a giant gastric cyst mimicking gastric lymphangioma: a case report and a brief review. BMC Gastroenterol 2021; 21:151. [PMID: 33823798 PMCID: PMC8022400 DOI: 10.1186/s12876-021-01686-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background Ectopic pancreas (EP) is defined as pancreatic tissue that lacks anatomical or vascular communication with the normal body of the pancreas. Despite improvements in diagnostic endoscopy and imaging studies, differentiating ectopic pancreatic tissue from gastric submucosal diseases remains a challenge. Case presentation Here, we present a case of a 44-year-old woman with severe epigastric pain. Initially, gastric lymphangioma was highly suspected due to a well-demarcated protruding mass with a large size that occurred in the submucosal layer of the gastric antrum and appeared as a cystic lesion. The final correct diagnosis of gastric EP was made during surgery. Conclusion Gastric EP with serous oligocystic adenoma appearing as a giant gastric cyst is extremely rare. The difficulty of making an accurate diagnosis and differential diagnosis is highlighted, which may provide additional clinical experience for the diagnosis of EP with serous oligocystic adenoma in the stomach.
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Affiliation(s)
- Xuemei Liu
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, Guizhou Province, China
| | - Xinglong Wu
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, Guizhou Province, China
| | - Biguang Tuo
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, Guizhou Province, China
| | - Huichao Wu
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, Guizhou Province, China.
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Ali HA, Zeriouh B, Bouzayan L, Jabi R, Bouziane M. Giant cystic lymphangioma of the stomach: A case report. Ann Med Surg (Lond) 2020; 61:8-12. [PMID: 33363719 PMCID: PMC7750175 DOI: 10.1016/j.amsu.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction Cystic lymphangioma is a benign tumor originating from the lymph vessels. It commonly occurs in childhood, in the head or neck regions. However, abdominal Cystic lymphangioma is extremely rare in adult patients and often asymptomatic. Considering abdominal space, it may attain huge sizes whilst causing minimal symptoms. Due to this insidious presentation, these tumors become massive and can be diagnosed late at the complication stage. Presentation of case This case report describes a rare and exceptional case of giant cystic lymphangioma of the stomach presented with a perforation in the abdominal cavity. The diagnosis was suspected following an abdominal CT scan, but could not confirm that the lesion was derived from the stomach. Therefore, an exploratory laparotomy found a multi-cystic mass occupying most of the abdominal space, adherent to the small gastric curvature and without delimitation line. This mass presents a small perforation responsible for an ascites of medium abundance. Then, the patient underwent a subtotal gastrectomy removing the entire cystic mass. Pathological analysis of the surgical specimen confirmed the diagnosis of cystic lymphangioma of the stomach. The postoperative recovery was uneventful, and the patient was discharged after 6 days. At the 3-month follow-up, the patient was in good health. Discussion The cystic lymphangioma of the stomach is rare and exceptionally described in the literature. However, if this tumor is benign, it has the potential to grow, invade vital structures, and develop life-threatening complications. Conclusion We stress the importance of complete surgical excision to prevent cyst complications and to reduce the recurrence risk. Cystic lymphangiomas of the stomach are rare benign tumors originating from the lymph. Its clinical presentation is usually variable and often asymptomatic. However, it can cause mass effect and result in serious complications. The radical resection remains a sufficiently safe and effective treatment to avoid cyst complications and recurrence risk. Long-term follow-up is required after incomplete resection.
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Affiliation(s)
- Hassane Ait Ali
- Department of General Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Brahim Zeriouh
- Department of General Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Leila Bouzayan
- Department of General Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Rachid Jabi
- Department of General Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Mohammed Bouziane
- Department of General Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
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Raufaste Tistet M, Ernst O, Lanchou M, Vermersch M, Lebert P. Imaging features, complications and differential diagnoses of abdominal cystic lymphangiomas. Abdom Radiol (NY) 2020; 45:3589-3607. [PMID: 32296900 DOI: 10.1007/s00261-020-02525-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of the study is to describe the imaging features, complications and differential diagnoses of abdominal cystic lymphangiomas (ACLs). RESULTS ACLs are benign lymphatic malformations that mainly arise in the subperitoneal space and the retroperitoneum. The typical presentation of an ACL is a multilocular lesion with homogenous serous content, presenting a thin wall and septa, usually free from adjacent organ compression. Atypical findings, including fat or hemorrhagic content, septal calcifications and unilocular presentation, are not uncommon. Rarely, ACLs can be revealed by acute complications, such as infection, hemorrhage, intussusception, complications with a twisting mechanism (including torsion around its own pedicle) or spontaneous rupture, which can be diagnosed by imaging. Ultrasonography and CT are the most useful modalities in emergency situations. MRI performs best in the noninvasive characterization of cystic lesions. ACLs should be differentiated from normal anatomic structures (e.g., cisterna chyli) or pitfalls (e.g., ascites, extrapancreatic necrosis, lymphocele) that can simulate ACLs. Among other primary peritoneal cystic lesions, benign cystic mesothelioma can be difficult to differentiate from ACL. Some neoplastic peritoneal lesions may have cystic components or content that looks like fluid on imaging (such as mucinous or myxoid content) and be misdiagnosed as ACL. Nodular or thick enhancement of the wall or septa should then be considered worrisome features and should not suggest ACL. ACLs mostly require a simple follow-up. If treatment is necessary, percutaneous sclerotherapy is a safe and effective alternative to surgery. CONCLUSION Imaging, especially MRI, allows the noninvasive diagnosis of ACL and helps to exclude potential malignant differential diagnoses.
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Affiliation(s)
- M Raufaste Tistet
- Department of Digestive Diagnostic and Interventional Radiology, University Hospital Claude Huriez - Regional University Hospital Center, rue Michel Polonoski, 59037, Lille Cedex, France.
| | - O Ernst
- Department of Digestive Diagnostic and Interventional Radiology, University Hospital Claude Huriez - Regional University Hospital Center, rue Michel Polonoski, 59037, Lille Cedex, France
| | - M Lanchou
- Department of Digestive Diagnostic and Interventional Radiology, University Hospital Claude Huriez - Regional University Hospital Center, rue Michel Polonoski, 59037, Lille Cedex, France
| | - M Vermersch
- Department of Digestive Diagnostic and Interventional Radiology, University Hospital Claude Huriez - Regional University Hospital Center, rue Michel Polonoski, 59037, Lille Cedex, France
| | - P Lebert
- Department of Digestive Diagnostic and Interventional Radiology, University Hospital Claude Huriez - Regional University Hospital Center, rue Michel Polonoski, 59037, Lille Cedex, France
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Mohammed AA, Musa DH. Lymphangioma of the ileum causing acute abdominal pain in an adult, a very rare finding during surgery; Case report with literature review. Int J Surg Case Rep 2020; 66:319-321. [PMID: 31901559 PMCID: PMC6940693 DOI: 10.1016/j.ijscr.2019.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/13/2019] [Accepted: 12/18/2019] [Indexed: 11/21/2022] Open
Abstract
Lymphangioma of the gastrointestinal tract is very rare, 75 % of the lesions affect the neck and 20 % affect the axillary region. The majority of cases are asymptomatic but some cases presented with emergency presentations. Complete surgical resection is the main form of therapy whenever possible.
Introduction Lymphangioma of the gastrointestinal tract is very rare, 75 % of the lesions affect the neck and 20 % affect the axillary region, the rest are seen in the mediastinum, the visceral organs, the retroperitoneum, the mesentery, or in the bones. Lymphangioma of the gastrointestinal tract comprises less than 1 %. The majority of cases are asymptomatic but some cases presented with emergency presentations. Case presentation A 31-year-old male presented to emergency department complaining of central abdominal pain for 2 days, with nausea, dyspnea but no vomiting. The abdominal examination revealed a mildly distended abdomen, with guarding and tenderness mainly in the right lower abdominal quadrant. There were no any palpable masses or organ enlargement. The white blood cells count was elevated (14,000 c/mm). Abdominal ultrasound showed an evidence of 10*7 cm multiloculated thick walled lesion in the right lower abdomen, suggesting the possibility of an appendicular abscess. The patient was admitted for 2 days with little clinical improvement. Therefore, a laparotomy was performed at which there were 2 yellowish cystic lesions 60 cm from the ileocecal valve that were arising from each side of the small bowel and related to its mesentery causing luminal narrowing. Resection was done with end-end anastomosis. The histopathology results revealed a diagnosis of ill lymphangioma of the ileum. Conclusion Complete surgical resection is the main form of therapy whenever possible, sometimes is impossible when there is local invasion. When complete resection is performed long term follow up is not recommended as the recurrence is very rare.
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Affiliation(s)
- Ayad Ahmad Mohammed
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
| | - Dildar Haji Musa
- Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
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Khan K, Kleess L, Ganga R, DePaz H, Santopietro R. Small bowel lymphangioma causing ileo-ileal intussusception in adults. Int J Surg Case Rep 2017; 41:469-472. [PMID: 29546019 PMCID: PMC5709314 DOI: 10.1016/j.ijscr.2017.11.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Lymphangioma is a rare benign tumor found in gastrointestinal tract. Most lymphangiomas can occur at any age and but mostly are found in children and infants. They are mainly due to malformation of the lymphatic system. They occur mainly in the head, neck and oral cavity, but less commonly develop in the abdominal cavity. Colonoscopy and endoscopic ultrasonography are frequently used to diagnose lymphangiomas of the small bowel. Ileo-ileal intussusception due to small bowel lymphangiomas has been rarely reported. Presentation of case We report a case of 24 year old female who presented to the hospital with sudden onset of right sided upper and lower abominal pain with nausea and vomiting, elevated WBC count of 15.1 μL. After careful examination and CT scan of Abdomen patient was found to have an ileo-ileal intussusception secondary to small bowel lymphangioma. In a rare clinical presented case, we performed a diagnostic laparoscopy (Fig. 1), exploratory laparotomy, small bowel resection, and stable primary anastomosis. Post-operative patient did well and was discharged on 4th post-operative day without complications. Discussion Lymphangiomas are rare benign tumors which have soft tissue consistency and often congenital malformation of the lymphatic system. Ileo-ileal intussusception in an adults can be a life threatening condition which requires prompt diagnosis and urgent intervention due to the risk of developing ischemic bowel. Prompt diagnosis and urgent intervention can lead to favourable. Conclusion We present this rare case of ileo-ileal intussusception secondary to small bowel lymphangioma with literature review.
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Affiliation(s)
- Khuram Khan
- Department of Surgery, Harlem Hospital Center, Columbia University, New York, USA.
| | - Lauren Kleess
- Department of Surgery, Montefiore New Rochelle Hospital, New York, USA
| | - Ram Ganga
- Department of Surgery, Montefiore New Rochelle Hospital, New York, USA
| | - Hector DePaz
- Department of Surgery, Harlem Hospital Center, Columbia University, New York, USA
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Ra JC, Lee ES, Lee JB, Kim JG, Kim BJ, Park HJ, Park SB, Choi BI. Diagnostic performance of stomach CT compared with endoscopic ultrasonography in diagnosing gastric subepithelial tumors. Abdom Radiol (NY) 2017; 42:442-450. [PMID: 27654991 DOI: 10.1007/s00261-016-0906-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate the diagnostic ability of multi-detector computed tomography (MDCT) compared to endoscopic ultrasonography (EUS) as a standard reference, and investigate the factors influencing the detection of small gastric subepithelial tumors (SETs) (<5 cm) on MDCT with stomach protocol. METHODS We retrospectively investigated 70 patients who were suspected with gastric SETs on esophagogastroduodenoscopy (EGD), and underwent both EUS and computed tomographic (CT) scanning. EUS was performed by two gastroenterologists, and location, size, echotexture, echogenicity, and layer of origin were described when gastric SETs were detected on EUS. MDCTs were reviewed based on consensus of two radiologists blinded to the EUS result. Size, location, enhancement pattern, and contour of the lesion detected on CT were described. We calculated the diagnostic ability of CT compared to EUS with respect to detection of gastric SETs, and investigated the factors influencing detection of SETs on CT. We also used receiver operating characteristic (ROC) curve to obtain optimal cut-off size for predicting CT visibility of small SETs. RESULTS Of the 70 patients, who underwent both CT and EUS due to suspicious presence of SET on EGD, EUS detected 56 probable cases of SET and 14 cases of external compression. CT led to detection of 39 cases of SET out of the 56 cases. Sensitivity and specificity of CT was 69.6% and 100.0%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of CT were 100.0% and 45.2%, respectively. There was a significant difference in mean size of CT-detected lesions compared to CT-invisible lesions (14.36 mm vs. 8.52 mm, p < 0.001), but no significant differences in terms of layer of origin and location between these two groups (p > 0.5) were observed. The ROC analysis revealed that the optimal cut-off value, also referred to prediction of CT visibility, was 10 mm. Out of 70 cases, 26 cases (37.14%) were identified as external compression or insignificant lesions such as lipoma, hemangioma, lymphangioma, or gastritis cystica on CT, and do not require regular follow-up. CONCLUSIONS Stomach CT shows good feasibility with respect to depiction of small SETs, especially in cases where size is larger than 10 mm. Henceforth, it is proposed that stomach CT would be a complimentary or problem-solving tool for SET in evaluating the presence of external compression and characterization of tumors.
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Affiliation(s)
- Joon Chul Ra
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea.
| | - Jong Beum Lee
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Jae Gyu Kim
- Department of Gastroenterology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Beom Jin Kim
- Department of Gastroenterology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Hyun Jeong Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
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Wang KF, Mo LQ, Kong DX. Role of mathematical medicine in gastrointestinal carcinoma: Current status and perspectives. Shijie Huaren Xiaohua Zazhi 2017; 25:114-121. [DOI: 10.11569/wcjd.v25.i2.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mathematical medicine has already played an important role in clinical and basic research as a major interdisciplinary branch of medicine. Mathematical medicine has an important role not only in imaging diagnosis, image storage and transmission in gastrointestinal (GI) cancer, but also in tumor precision therapy. Specifically, in the field of minimally invasive treatment such as precise ablation, 3-dimension modeling, navigation, and surgical simulation significantly improve the therapeutic safety and efficiency in GI cancer. In addition, in the era of big data, data analysis and individualized therapy using mathematical medicine will become a trend in the future, offering an effective method for diagnosing and treating GI cancer and promoting clinical and scientific research.
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Chen G, Liu M, Malik TH, Li S, Tang Y, Xu H. Giant cystic lymphangioma originating from the cardia of the stomach: A case report. Exp Ther Med 2016; 11:1943-1946. [PMID: 27168832 DOI: 10.3892/etm.2016.3090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 01/11/2016] [Indexed: 01/29/2023] Open
Abstract
Cystic lymphangiomas are rare benign tumors involving the neck, head, and axilla, and most frequently occur in children before the age of 5 years. In the present study, the case of a giant cystic lymphangioma originating in the cardia of the stomach was reported in an 18-year-old female complaining of abdominal distention. Contrast-enhanced computed tomography and endoscopic ultrasonography revealed a large, multilobulated cystic mass located between the cardia and esophagogastric junction with a diameter of 4.0 cm. The lesion was successfully removed by endoscopic submucosal dissection. Subsequent immunohistochemical analysis of the lymphatic endothelium-specific O-linked sialoglycoprotein D2-40 confirmed the diagnosis of cystic lymphangioma. No complications associated with the tumor dissection occurred, and the patient did not report any further complaints or any signs of recurrence at 6- and 18-month follow-up. The present case demonstrates that a diagnosis of cystic lymphangioma should be considered in non-pediatric patients suffering aspecific abdominal complaints.
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Affiliation(s)
- Geng Chen
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Mingqing Liu
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Tayyab Hamid Malik
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Shouying Li
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Ying Tang
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hong Xu
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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Arraiza M, Metser U, Vajpeyi R, Khalili K, Hanbidge A, Kennedy E, Ghai S. Primary cystic peritoneal masses and mimickers: spectrum of diseases with pathologic correlation. ACTA ACUST UNITED AC 2015; 40:875-906. [PMID: 25269999 DOI: 10.1007/s00261-014-0250-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cystic lesions within the peritoneum have been classified classically according to their lining on histology into four categories-endothelial, epithelial, mesothelial, and others (germ cell tumors, sex cord gonadal stromal tumors, cystic mesenchymal tumors, fibrous wall tumors, and infectious cystic peritoneal lesions). In this article, we will proceed to classify cystic peritoneal lesions focusing on the degree of radiological complexity into three categories-simple cystic, mildly complex, and cystic with solid component lesions. Many intra-abdominal collections within the peritoneal cavity such as abscess, seroma, biloma, urinoma, or lymphocele may mimic primary peritoneal cystic masses and need to be differentiated. Clinical history and imaging features may help differentiate intra-abdominal collections from primary peritoneal masses. Lymphangiomas are benign multilocular cystic masses that can virtually occur in any location within the abdomen and insinuate between structures. Ultrasound may help differentiate enteric duplication cysts from other mesenteric and omental cysts in the abdomen. Double-layered wall along the mesenteric side of bowel may suggest its diagnosis in the proper clinical setting. Characteristic imaging features of hydatid cysts are internal daughter cysts, floating membranes and matrix, peripheral calcifications, and collagenous pericyst. Non-pancreatic psuedocysts usually have a fibrotic thick wall and chylous content may lead to a fat-fluid level. Pseudomyxoma peritonei appears as loculated fluid collections in the peritoneal cavity, omentum, and mesentery and may scallop visceral surfaces. Many of the primary cystic peritoneal masses have specific imaging features which can help in accurate diagnosis and management of these entities. Knowledge of the imaging spectrum of cystic peritoneal masses is necessary to distinguish from other potential cystic abdominal mimicker masses.
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Affiliation(s)
- María Arraiza
- Joint Department of Medical Imaging, University Health Network - Mount Sinai Hospital - Women's College Hospital, University of Toronto, 585 University Avenue, Toronto, ON, M5G 2N2, Canada
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Lee J, Park CM, Kim KA, Lee CH, Choi JW, Shin BK, Lee SJ, Choi D, Jang KT. Cystic lesions of the gastrointestinal tract: multimodality imaging with pathologic correlations. Korean J Radiol 2010; 11:457-68. [PMID: 20592930 PMCID: PMC2893317 DOI: 10.3348/kjr.2010.11.4.457] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 03/24/2010] [Indexed: 02/07/2023] Open
Abstract
The cystic lesions of the gastrointestinal (GI) tract demonstrate the various pathologic findings. Some lesions may present a diagnostic challenge because of non-specific imaging features; however, other lesions are easily diagnosed using characteristic radiologic features and anatomic locations. Cystic masses from the GI tract can be divided into several categories: congenital lesions, neoplastic lesions (cystic neoplasms, cystic degeneration of solid neoplasms), and other miscellaneous lesions. In this pictorial review, we describe the pathologic findings of various cystic lesions of the GI tract as well as the radiologic features of GI cystic lesions from several imaging modalities including a barium study, transabdominal ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging.
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Affiliation(s)
- Jongmee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea.
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Kang JH, Lim JS, Kim JH, Hyung WJ, Chung YE, Choi JY, Park MS, Kim MJ, Kim KW. Role of EUS and MDCT in the diagnosis of gastric submucosal tumors according to the revised pathologic concept of gastrointestinal stromal tumors. Eur Radiol 2008; 19:924-34. [PMID: 19023576 DOI: 10.1007/s00330-008-1224-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2008] [Accepted: 10/20/2008] [Indexed: 12/22/2022]
Abstract
Gastric submucosal tumors (SMTs) consist of various lesions arising from the deep layers of the stomach. Gastrointestinal stromal tumors (GISTs) are undoubtedly the commonest malignant SMTs of the stomach, and therefore the attitude towards the general diagnostic approach for GISTs defines the extended diagnostic plan for SMTs. Two recent consensus meetings were assembled concerning the classification and therapeutic plans for GISTs. These meetings shed light upon the need for the modification of the current role of imaging modalities, including endoscopic ultrasound (EUS) and computed tomography (CT). According to the revised concepts of GISTs, the most important and plausible current role of imaging for the diagnostic approach of gastric SMTs is to differentiate GISTs from other gastric SMTs. This review discusses the newly established diagnostic role of radiology according to the revised classification of GISTs and provides the differential diagnoses based on EUS and CT findings.
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Affiliation(s)
- Jung-Ho Kang
- Department of Diagnostic Radiology, Yonsei University Health System, Seoul, Republic of Korea
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