Splenic lymphangioma in adulthood: A case report

Splenic lymphangioma masquerading as splenic abscess managed by laparoscopic splenectomy: A case report

BACKGROUND

Primary benign splenic tumours are unique and account for < 0.007% of all tumours identified during surgery and autopsy. Splenic lymphangiomas are rarely seen in adults. Splenic lymphangiomas may be asymptomatic, or may present with upper left abdominal pain, splenomegaly, hypersplenism, or splenic rupture with haemorrhagic shock. The clinical and radiological features of these lesions are not specific. This case report serves to remind the clinician to consider the rare but important differential diagnosis of splenic lymphangioma while treating splenic lesions.

CASE SUMMARY

We report a case of splenic lymphangioma in a 22-year-old woman who presented with left upper quadrant abdominal pain for three months. Initial investigations were unremarkable; however, computed tomography later revealed multiple splenic micro-abscesses. The patient underwent laparoscopic splenectomy, and histopathological examination revealed splenic lymphangioma. The patient was discharged on postoperative day three. One month after surgery, the abdominal pain resolved completely, with no new complaints. Splenic lymphangiomas present clinically as splenomegaly or left upper quadrant abdominal pain; prompt intervention is necessary for avoiding complications.

CONCLUSION

This case report concludes that splenic lymphangiomas should be considered in the differential diagnosis of splenomegaly or left upper quadrant pain, even in adults, because they are amenable to curative treatment. Delays in surgical intervention may lead to severe complications, such as infection, rupture, and hemorrhage. Such lesions can be safely managed with laparoscopy, involving less postoperative pain and early patient discharge with excellent cosmetic outcomes.

Splenic Lymphangioma Mimicking Lymphomatous Involvement: A Case Report with Review of the Literature

Lymphangioma is a benign malformation of lymphatic vessels usually found in the head and neck areas or axilla. They may involve visceral organs with a lower percentage. Splenic lymphangioma is a rare tumor. This disease is often seen in children but may be diagnosed incidentally in adults. Most patients are asymptomatic, but in large and multifocal lesions, the patient may have some nonspecific symptoms such as abdominal pain, abdominal distention, nausea, vomiting, and loss of appetite. Physical examination may show no specific findings or detect palpable masses. The preoperative diagnosis of splenic lymphangioma is challenging. Histopathological evaluation and sometimes immunohistochemistry tests can result in a definitive diagnosis. In this study, we present an 18-year-old man, with Burkitt's lymphoma who underwent laparotomy and total splenectomy as a result of cystic lesions discovered accidentally during imaging with the final diagnosis of splenic lymphangioma after histopathological evaluation.

Review of diagnosis, differential diagnosis, and management of retroperitoneal lymphangioma

Lymphatic malformation (LM) is the currently preferred term for what was previously known as lymphangioma. Retroperitoneal LMs are extremely rare, benign, cystic masses that arise from lymphatic vessels. They can be challenging to diagnose because they resemble other retroperitoneal cystic tumors. The development of treatment strategies for rare diseases, including retroperitoneal LM, requires the acquisition of new knowledge to enhance our understanding of the disease progression. Therefore, we present an update regarding fundamental and advanced issues associated with retroperitoneal LM. This review describes the epidemiology, histopathology, biomedicine, clinical manifestations, radiological features, differential diagnosis, and management of this lesion.

Splenic lymphangioma in adult patient treated with laparoscopic splenectomy: A rare case report

Splenic lymphangioma is a benign cystic tumor that develops as a result of lymphatic vessels' congenital abnormalities. It is a rare condition that mostly occurs in children and young adults. Due to the lack of typical symptoms and signs, splenic lymphangioma is difficult to diagnose and often incidentally revealed during radiological examinations. We report a case of a 55-year-old Asian female, who presented with left upper quadrant abdominal pain in the past 3 days. She had mild upper abdominal tenderness, with no other specific findings. Abdominal contrast material-enhanced computed tomography revealed three hypodense lesions arising from a normal-sized spleen. The histologic findings after laparoscopic splenectomy demonstrated a 3-cm-diameter yellowish-white tumor made up of multiple cystic structures. Primary benign splenic tumors are exceedingly rare, especially in adults over 20. While small lesions are mostly asymptomatic, bigger lesions can cause organ compression or even rupture. Therefore, even in adults with pain in the left upper quadrant abdomen or enlarged spleen, splenic lymphangioma should be taken into account in the differential diagnosis. The case serves as an example of a rare congenital splenic tumor. Treatment of this benign splenic abnormality with laparoscopic splenectomy is a good, safe approach.

Splenic lymphangiomas as a common indication for splenectomy: a case series with literature review

BACKGROUND

Splenic lymphangiomas (SL) are very rare benign cystic lesions found in pediatric population. Their occurrence in adults is exceptional. Splenectomy is the common management of splenic lesions for diagnostic and/or therapeutic purpose. Our aim is to report additional cases of SL diagnosed on splenectomy specimens at our Pathology laboratory with literature review.

METHODS

This is a retrospective study including all cases of splenectomy recorded at our Pathology laboratory (June 2020-August 2022). We performed a comparison of clinicopathological features between patients with SL and those with other benign splenic diseases.

RESULTS

Sixteen cases of splenectomy were included. The mean age was 30.25 years (range of 6-70 years). The final histopathological diagnoses were congestive spleens in all cases of sickle cell disease (SCD) (5/16 patients, 31.25%), splenic cystic lymphangiomas (4/16 patients, 25%), capsular splenic infiltration by gastric and colic cancers (3/16 cases, 18.75%), splenic abscess (2/16 cases, 12.5%) and splenic rupture with subcapsular hematoma (1/16 patients, 6.25%). 12/16 patients (75%) had benign splenic conditions (4/12 with SL, 5/12 with SCD, 2/12 with abscess and 1/12 with splenic trauma). Patients with SL were older than those with other benign splenic conditions (mean age of 28.27 years versus 20.87 years). Also patients with SL presented with massive splenomegaly (mean splenic weight of 1675 g versus 418.75 g, mean splenic size of 19.62 cm versus 14.63 cm). Open surgery was performed in 15/16 patients (93.75%).

CONCLUSION

Unlike previous studies, our series shows that SL are a common indication for splenectomy and occur in older patients with massive cystic splenomegaly. Open splenectomy is still an usual surgical practice in our country.

Splenic cystic lymphangioma in adults: A rare case report from Syria

Introduction and importance

Splenic lymphangiomas are an extremely rare entity that is mainly diagnosed in children. They are often found in the neck and axilla region. Cystic lymphangioma in the abdomen is unusual and the spleen is an exceptional location for lymphangiomas.

Case presentation

We report a case of a 73 - year - old woman who presented with abdominal pain in the left upper quadrant for a month. Abdominal imaging studies show multiple splenic cysts. Splenectomy was performed and the specimen was sent for histopathologic examination. Microscopic inspection revealed splenic lymphangioma.

Clinical discussion

Splenic lymphangiomas are uncommon lesions. Most cases have been reported in children. The head, neck, and axillary regions are the most common sites, whereas lymphangioma in the spleen is exceptional.

Conclusion

Splenic lymphangiomas are uncommon benign tumors that are rarely seen during adulthood. Splenectomy is the preferred treatment.

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Lymphangiomas are rare benign tumors of the lymphatic vessels, mainly found in children but rarely in adults.

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We report a case of a 73-years old woman with splenic cystic lymphangioma.

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Lymphangioma in the spleen is extremely rare. Clinically, it is usually asymptomatic.

Characteristics of adult abdominal cystic Lymphangioma: a single-center Chinese cohort of 12 cases

Background

Cystic lymphangioma is a rare, benign developmental disease, mostly affecting the cervical and axial regions. The clinical features of abdominal cystic lymphangioma (ACL) are reported among pediatric patients but are less well known in adults. The purpose of this study was to demonstrate the clinical characteristics of ACL in Chinese adults and describe our experience in treating this disease.

Methods

We conducted a single-center, non-interventional, retrospective study of 12 adult patients with ACL admitted to Peking Union Medical College Hospital in Beijing, China from November 1984 through August 2017. The demographic, clinical, laboratory, imaging, histopathologic, and therapeutic data were collected.

Results

Detailed information on seven males and five females was available. The mean age at diagnosis was 39.1 (SD 17.3) years. The mean duration of follow-up was 6.9 years. Six (50%) patients were asymptomatic, and abdominal pain was the leading symptom for three (25%) patients. The cysts were evaluated by ultrasound (n = 8, 67%), CT (n = 10, 83%), and MRI (n = 4, 33%). Therapeutic modalities include laparotomy (n = 6, 50%), laparoscopy (n = 4, 33%), and aspiration (n = 2, 17%), with variable outcomes. The mean postsurgical hospital stay was 6.8 days. Complete excision was accomplished in eight patients, and one recurrence was observed during follow-up. Of patients who underwent partial resection, one experienced disease relapse.

Conclusions

This is the first report on an Asian cohort of adult patients with ACL. Typical imaging features could lead to timely diagnosis and treatment of ACL. Radical resection is recommended with a longer period of follow-up. The analysis of this cohort deepens our understanding of adult ACL.