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Review of diagnosis, differential diagnosis, and management of retroperitoneal lymphangioma. Jpn J Radiol 2023; 41:283-301. [PMID: 36327088 DOI: 10.1007/s11604-022-01356-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
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.
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Rosales-Parra ND, Acero-Murillo CF, García-Aristizabal MP, Romero-Espitia WD. Malformaciones linfáticas abdominales en una población pediátrica: experiencia en un centro de referencia de Medellín, Colombia. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. Los linfangiomas son anormalidades benignas del sistema linfático, que corresponden a dilataciones quísticas de estos vasos y se localizan especialmente en el cuello. Solo el 10 % de todas estas malformaciones se encuentran en el abdomen y presentan síntomas variables de acuerdo al tamaño y su ubicación especifica, siendo el dolor abdominal el principal síntoma.
Métodos. Se presentan cinco pacientes pediátricos con malformaciones linfáticas abdominales. Se describen su cuadro clínico, localización, tratamiento y la experiencia en el manejo de dicha patología en un hospital de referencia.
Resultados. Los métodos más apropiados para hacer una aproximación diagnóstica son la ecografía, la tomografía computarizada y la resonancia nuclear magnética. Dentro de las opciones descritas para el tratamiento están la farmacológica, la escleroterapia y la resección quirúrgica, tanto por vía abierta como por laparoscopia.
Conclusión. Existe una variedad de métodos para realizar la resección de los linfangiomas abdominales, pero la cirugía sigue siendo la más efectiva, especialmente cuando se cuenta con la laparoscopia como una herramienta terapéutica.
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3
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Kaye R, Leddy R. Pediatric breast lymphatic malformation with recurrent presentation in an adolescent female. BJR Case Rep 2022; 8:20210077. [PMID: 35136635 PMCID: PMC8803227 DOI: 10.1259/bjrcr.20210077] [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: 04/12/2021] [Revised: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
This case report summarizes a rare case of left chest wall/breast lymphatic malformation or cystic lymphangioma in a female child of 18 months with multiple late recurrences in adolescence. By maternal history, the mass was excised initially, but the patient presented at age 15 and 17 years for recurrences and associated symptoms. Comments focus on a complex clinical history and treatment management of patient symptoms and concerns. Breast sparing treatments were employed with sclerotherapy and the T lymphocyte inhibitor, Sirolimus (Rapamune).
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Affiliation(s)
- Rachel Kaye
- Medical University of South Carolina, Charleston, South Carolina, United States
| | - Rebecca Leddy
- Department of Radiology and Radiological Science, Medical University of South Carolina, Breast Imaging, Charleston, South Carolina, United States
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4
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Locker SH, Maxwell EA, Vilaplana Grosso F, Bertran J, Shiomitsu K. Novel treatment of recurrent abdominal lymphatic malformations in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Seth H Locker
- Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Elizabeth A Maxwell
- Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Federico Vilaplana Grosso
- Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Judith Bertran
- Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Keijiro Shiomitsu
- Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
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Hutchison DM, Crosland BA, Wang L, Nageotte MP. Massive unilateral fetal axillary lymphangioma: A case report. Case Rep Womens Health 2021; 31:e00319. [PMID: 34036052 PMCID: PMC8138721 DOI: 10.1016/j.crwh.2021.e00319] [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: 04/07/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/15/2022] Open
Abstract
We report a substantial axillary lymphangioma in a fetus delivered at 38 weeks of gestation. Detailed fetal survey at 20 weeks revealed a 5.45 × 3.72 cm nonvascular cystic axillary structure without other malformations; amniocentesis was negative. Serial surveillance was performed throughout the pregnancy. A male infant weighing 3000 g with a 16 × 12 × 9 cm septated cystic mass arising from the left axilla was delivered via cesarean section. The newborn period was complicated by cellulitis overlying the mass and interval cystic hemorrhage requiring sclerotherapy and subsequent excision. Nonnuchal lymphangiomas may be etiologically distinct entities. The prognostic factors include anatomic location, presence of septa, and association with other congenital abnormalities. A thorough evaluation, multidisciplinary approach, and close surveillance should be undertaken to optimize neonatal outcomes.
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Affiliation(s)
| | - Brian A Crosland
- University of California, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Irvine, USA.,Miller Children's and Women's Hospital, Long Beach Memorial Medical Center, USA
| | - Larry Wang
- Children's Hospital Los Angeles, Department of Pathology, USA
| | - Michael P Nageotte
- Miller Children's and Women's Hospital, Long Beach Memorial Medical Center, USA
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Mukakala AK, Banza MI, Musapudi EM, Lubosha NA, Kasanga TK, Nafatalewa DK, Yumba SN, Ngabunda PM, Mwenibamba RM. [Cystic hygroma of the neck in a young adult: about a case and literature review]. Pan Afr Med J 2020; 36:54. [PMID: 32774629 PMCID: PMC7388595 DOI: 10.11604/pamj.2020.36.54.21758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 11/11/2022] Open
Abstract
Cystic hygromas are congenital malformations affecting the lymphatic system. These are rare benign dyssembryoplastic lesions mainly affecting the head and neck, in particular the posterior triangle of the neck. They usually occur during childhood and exceptionally in adults. We here report a clinical case of cystic hygroma of the neck in a 22-year old subject.
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Affiliation(s)
- Augustin Kibonge Mukakala
- Département de Chirurgie, Cliniques Universitaires de Bukavu, Faculté de Médecine, Université Officielle de Bukavu, République Démocratique du Congo
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Manix Ilunga Banza
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Eric Mbuya Musapudi
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Nasser Amisi Lubosha
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Trésor Kibangula Kasanga
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Dimitri Kanyanda Nafatalewa
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Serge Ngoie Yumba
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Papy Mukimba Ngabunda
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo
| | - Rodrigue Mupenda Mwenibamba
- Département de Chirurgie, Cliniques Universitaires de Bukavu, Faculté de Médecine, Université Officielle de Bukavu, République Démocratique du Congo
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Moradi A, Kazemzadeh Azad B, Fasihi M, Aliakbari F. Bladder Lymphangioma Treated by Holmium Laser: Extremely Rare Case Report. J Lasers Med Sci 2020; 11:226-227. [PMID: 32273967 DOI: 10.34172/jlms.2020.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Lymphangioma is a sporadic benign tumor of the bladder. It is a congenital disorder and based on the size of lymphatic spaces, it is divided into 3 types of capillary, cavernous, and cystic. Case Report: In this paper, we presented a 40-year-old woman with microscopic hematuria and a normal urinary ultrasound. Urethrocystoscopy showed a flat 4 mm highlighted strawberry-like lesion on the right lateral wall of the bladder. After a cold cup biopsy, the lesion was coagulated by the holmium: YAG (Ho: YAG) laser. Conclusion: In Bladder Lymphangioma Based on the size of the lesion, partial cystectomy or minimally invasive surgeries such as laser modality would be the principal treatment.
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Affiliation(s)
- Asaad Moradi
- Department of Urology, Firozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Kazemzadeh Azad
- Men's Health & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahyar Fasihi
- Department of Urology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Aliakbari
- Men's Health & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tan DTM, Chok AY, Farah BL, Yan YY, Toh EL. Spontaneous partial regression of a microcystic jejunal mesenteric lymphangioma and a proposed management algorithm. BMJ Case Rep 2019; 12:12/11/e231037. [PMID: 31767604 DOI: 10.1136/bcr-2019-231037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Mesenteric lymphangiomas are relatively rare, with clinical symptoms ranging from an asymptomatic presentation to an acute abdomen. The natural history and biological behaviour of this entity can range from slow indolent lesions to aggressive tumours with a risk of malignant transformation. Spontaneous regression of a mesenteric lymphangioma is rare. We herein report a case of a jejunal mesenteric lymphangioma that was initially detected incidentally in an asymptomatic patient with a subsequent sudden increase in size with resulting surrounding mass effect after 9 months and a spontaneous partial regression at surgical resection. Our case is the first reported case which outlines a period in the natural history and evolution of microcystic mesenteric lymphangioma, illustrating the sudden enlargement likely attributable to spontaneous and self-limiting haemorrhage and subsequent partial regression at surgical resection. We thenceforth propose a possible management algorithm for adult patients with mesenteric lymphangiomas.
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Affiliation(s)
- Dominic Ti Ming Tan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK .,Department of Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Aik Yong Chok
- Department of Colorectal Surgery, Singapore General Hospital, Bukit Merah, Singapore
| | - Benjamin Livingston Farah
- Division of Pathology, Department of Anatomical Pathology, Singapore General Hospital, Bukit Merah, Singapore
| | - Yet Yen Yan
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore
| | - Ee-Lin Toh
- Department of Colorectal Surgery, Singapore General Hospital, Bukit Merah, Singapore
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Nagano H, Kimura T, Iida A, Togawa T, Goi T, Sato Y. Cystic lymphangioma in the peripheral jejunal mesentery in an adult and excision with laparoscopic-assisted surgery: a case report. World J Surg Oncol 2019; 17:170. [PMID: 31651341 PMCID: PMC6814111 DOI: 10.1186/s12957-019-1713-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background Lymphangiomas are uncommon congenital malformations that present mainly in the head, neck, and axillar regions in pediatric patients. Mesenteric cystic lymphangiomas (MCLs), which occasionally present with substantial growth and the invasion of adjacent vital structures, are rarely reported in adults. We report a case of MCL in an adult who was treated with laparoscopic-assisted excision. Case presentation A 40-year-old Japanese man visited his family physician for prolonged periumbilical pain. Plain computed tomography (CT) showed a low-density mass in his left abdomen, and he was referred to our hospital 2 weeks later. His abdomen was flat and soft, and no mass was felt upon palpation. Routine laboratory data showed no abnormalities in the blood cell counts. The levels of tumor markers, such as carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125 (CA125), were within normal ranges. Contrast-enhanced CT was performed, and a low-density mass was observed with an irregular outline and poor contrast, as well as involvement of the peripheral mesenteric artery and partial compression of the adjacent jejunum without dilatation of the oral side of the bowel. The patient was diagnosed with lymphatic cysts and observed for 1 month without symptom exacerbation. Follow-up CT showed no increase in the size of the mass but showed apparent invasion of the jejunal wall without bowel obstruction. Magnetic resonance imaging (MRI) showed intermediate intensity on T1-weighted imaging (T1WI) and high intensity on T2-weighted imaging (T2WI). The coronal view on T2WI clearly showed an accumulation of cystic lesions. We performed tumor excision with partial resection of the jejunum in a laparoscopic-assisted manner. Pathological examination showed multicystic lesions with an attenuated endothelial lining, surrounding rich adipose tissue and scattered smooth muscle fibers; the patient was diagnosed with MCL. Immunohistochemical assays supported this diagnosis. Conclusions This is rare case of MCL presenting in an adult who underwent successful laparoscopic-assisted resection. Mesenteric lymphangioma (ML) should be considered in the differential diagnosis of patients with intraabdominal cysts. Radical excision is optimal, even when the patient is asymptomatic. Laparoscopic-assisted tumor resection is a suitable surgical method for treating MLs located in the peripheral mesentery.
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Affiliation(s)
- Hideki Nagano
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan.
| | - Toshihisa Kimura
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan
| | - Atsushi Iida
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan
| | - Tamotsu Togawa
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan
| | - Takanori Goi
- First Department of Surgery, Faculty of Medicine, University of Fukui, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yasunori Sato
- Department of Human Pathology Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
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Kolay SK, Parwani R, Wanjari S, Singhal P. Oral lymphangiomas - clinical and histopathological relations: An immunohistochemically analyzed case series of varied clinical presentations. J Oral Maxillofac Pathol 2018; 22:S108-S111. [PMID: 29491618 PMCID: PMC5824501 DOI: 10.4103/jomfp.jomfp_157_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lymphangiomas are benign malformations that represent hamartoma of malformed lymphatics and are composed of cystically dilated lymphatic channels which do not communicate or drain into other lymphatic channels or veins leading to accumulation of lymph. They are congenital malformations with rare occurrence in oral cavity within which tongue dorsum is the most affected site. Venous malformations are often difficult to differentiate from lymphatic malformations leading to the development of several lymphatic markers like D2-40 which seems to be useful for distinguishing vascular from lymphatic vessels. The most effective treatment is surgery having good prognosis for most of the patients but depending on their location (neck/tongue) and size (large size) they may cause airway obstruction causing death. Herewith, we present the rare cases of oral lymphangiomas of tongue, palate and buccal mucosa with varied and characteristic clinical presentations.
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Affiliation(s)
| | - Rajkumar Parwani
- Department of Oral and Maxillofacial Pathology, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Sangeeta Wanjari
- Department of Oral and Maxillofacial Pathology, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Pallav Singhal
- Department of Oral Pathology and Microbiology, Sarjug Dental College, Darbhanga, Bihar, India
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12
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Musapudi EM, Bwalya AL, Mujinga IMW, Mujinga DT, Nikulu JI, Ilunga GN. [Lymphangioma of the breast: about a case]. Pan Afr Med J 2017; 28:23. [PMID: 29138659 PMCID: PMC5681013 DOI: 10.11604/pamj.2017.28.23.12318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/18/2017] [Indexed: 12/02/2022] Open
Abstract
Lymphangioma is a benign lesion of the lymphatic vessels. It is a rare paediatric condition and it is exceptional among adults. It mainly occurs in the neck, armpit and abdomen. It rarely occurs in the breast. We report the case of a 18 year-old female patient seen in consultation for a mass in her left breast, which had evolved over the last 23 months. Management was based on surgery. The patient underwent complete tumor resection. Anatomopathological examination showed lymphangioma of the breast. Patient's evolution was favorable and the patient had a median 10 months follow-up with no recurrences identified.
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Affiliation(s)
- Eric Mbuya Musapudi
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, Republique Démocratique du Congo
| | - Aimé Lukoba Bwalya
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, Republique Démocratique du Congo
| | - Igor Mujinga Wa Mujinga
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, Republique Démocratique du Congo
| | - Didier Tshibangu Mujinga
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, Republique Démocratique du Congo
| | - Julien Ilunga Nikulu
- Pathologiste Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, Republique Démocratique du Congo
| | - Guy Nday Ilunga
- Département de Chirurgie, Cliniques Universitaires de Lubumbashi, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, Republique Démocratique du Congo
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Kumar B, Bhatnagar A, Upadhyaya VD, Gangopadhyay AN. Small Intestinal Lymphangioma Presenting as an Acute Abdomen with Relevant Review of Literature. J Clin Diagn Res 2017; 11:PD01-PD02. [PMID: 28764241 DOI: 10.7860/jcdr/2017/22703.9962] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/19/2016] [Indexed: 11/24/2022]
Abstract
Cystic lymphangioma of small bowel mesentery is rare with clinical features ranging from an asymptomatic abdominal lump to acute intestinal obstruction. We discuss two cases of lymphangioma of small bowel mesentery who presented to us as acute intestinal obstruction. In the first case exploratory laparotomy revealed a large multicystic lesion arising from small bowel mesentery just distal to the duodenojejunal junction having multiple small cysts filled with milky white fluid. The involved region of the bowel was excised. The second case had a large multicystic lesion involving the mesentery of proximal jejunum, dudenojejunal junction, encasing the entire superior mesenteric vessels. For this patient, debulking was done.
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Affiliation(s)
- Basant Kumar
- Associate Professor, Department of Paediatric Surgery, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Ankur Bhatnagar
- Associate Professor, Department of Plastic Surgery, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Vijai Datta Upadhyaya
- Associate Professor, Department of Paediatric Surgery, SGPGIMS, Varanasi, Uttar Pradesh, India
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