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Pu Y, Yuan Z, Li J, Luo Y. Value of contrast-enhanced ultrasound in the diagnosis of retroperitoneal cystic lymphangioma: A case report. Asian J Surg 2024:S1015-9584(24)01212-0. [PMID: 38890048 DOI: 10.1016/j.asjsur.2024.05.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/31/2024] [Indexed: 06/20/2024] Open
Affiliation(s)
- Yang Pu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiqiang Yuan
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Jiawu Li
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
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Kharkhach A, Rhoul C, Police A, Mabilia A. A ruptured mesenteric lymphangioma causing peritonitis: a case report. J Surg Case Rep 2024; 2024:rjae319. [PMID: 38764732 PMCID: PMC11102783 DOI: 10.1093/jscr/rjae319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/27/2024] [Indexed: 05/21/2024] Open
Abstract
Cystic lymphangioma is a rare disease that is mainly diagnosed in childhood. When diagnosed, the lesion presents an indication for surgery due to the risk of serious complications. Herein, we report the case of a 32-year-old patient who presented to the emergency room for abdominal pain that developed 2 days before with worsening symptoms and abdominal pain in the last 24 hr. The computed tomography showed diffuse wall thickening of the jejunum and proximal ileum with mesenteric fat infiltration, a mesenteric collection, and a moderate volume of ascites extending into the pelvis. A laparotomy was performed, revealing diffuse chemical peritonitis with a crater-like lesion in the jejunal mesentery, secreting lymphatic fluid. The mesenteric lesion was then excised, and the histological examination showed a ruptured cystic lymphangioma. Lymphangiomas of the small bowel mesentery are rare and may be exceptionally associated with bowel occlusion or peritonitis.
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Affiliation(s)
- Ayoub Kharkhach
- Department of General Surgery, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda 60000, Morocco
- Department of Visceral and Digestive Surgery, Simone Veil Hospital, Eaubonne 95600, France
| | - Chafik Rhoul
- Department of General Surgery, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda 60000, Morocco
- Department of Visceral and Digestive Surgery, Simone Veil Hospital, Eaubonne 95600, France
| | - Andrea Police
- Department of Visceral and Digestive Surgery, Simone Veil Hospital, Eaubonne 95600, France
| | - Andrea Mabilia
- Department of Visceral and Digestive Surgery, Simone Veil Hospital, Eaubonne 95600, France
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Quintanar-Martínez M, Manzano-Robleda MDC, Murcio-Pérez E, López-Arce G, Bartnicki-Navarrete I, Uscanga L, Hernández-Guerrero A, López-Cossio J, Villalobos-Garita A, Perales-Oliva J, Vargas-Jimenez J, Téllez-Ávila F. Pathology results of endoscopic ultrasound-guided tissue acquisition in retroperitoneal masses: a multicenter study. Ann Gastroenterol 2024; 37:104-108. [PMID: 38223242 PMCID: PMC10785020 DOI: 10.20524/aog.2024.0846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/30/2023] [Indexed: 01/16/2024] Open
Abstract
Background Malignant etiologies are found in 70-80% of symptomatic retroperitoneal masses. Histology is required for diagnosis and treatment. Information about endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-GTA) is scant for retroperitoneal masses. This study aimed to assess the pathology results of EUS-GTA for diagnosing retroperitoneal masses. Methods This retrospective, multicenter study involved patients from 5 care centers. All patients with retroperitoneal masses who underwent EUS evaluation were enrolled. We recorded demographic and clinical characteristics, location and size of the mass, type of needle (FNA/FNB), and complications related to the procedure. Results A total of 43 patients were included. The median age was 50.5 (range: 23-83) years, and 22 (51.2%) were female. The initial symptom was abdominal pain in 23 (52.3%) cases and weight loss in 11 (25%). Initial imaging was by computed tomography in 33 (75%) patients. Diagnosis with EUS-GTA was reached in 67.5% (29/43) cases. The most frequent histological diagnosis was carcinoma, in 25.5% (11/43). A malignant etiology was found in 31 (72%): 20 were primary tumors from the retroperitoneum, and 11 were metastases. In patients with metastasis, surgery was avoided and medical treatment was indicated. No adverse events were reported. Conclusion EUS and EUS-GTA can frequently provide accurate tissue diagnosis and significantly impact the subsequent management.
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Affiliation(s)
- Mariana Quintanar-Martínez
- Department of Gastrointestinal Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México (Mariana Quintanar-Martínez)
| | - Maria del Carmen Manzano-Robleda
- Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Angélica Hernández-Guerrero)
- Gastroenterology Department, Medica Sur Clinic and Foundation, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Jorge Perales-Oliva)
| | - Enrique Murcio-Pérez
- Department of Endoscopy, National Medical Center Century XXI, IMSS, Ciudad de México, México (Enrique Murcio-Pérez, Isaac Bartnicki-Navarrete)
| | | | - Isaac Bartnicki-Navarrete
- Department of Endoscopy, National Medical Center Century XXI, IMSS, Ciudad de México, México (Enrique Murcio-Pérez, Isaac Bartnicki-Navarrete)
| | - Luis Uscanga
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México (Luis Uscanga)
| | - Angélica Hernández-Guerrero
- Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Angélica Hernández-Guerrero)
| | - Jorge López-Cossio
- Hospital del Prado, Tijuana, Baja California, México (Jorge López-Cossio)
| | - Alvaro Villalobos-Garita
- Department of Gastroenterology and Digestive Endoscopy, Hospital Calderón Guardia/Clínica Biblíca, San José Costa Rica (Alvaro Villalobos-Garita José Vargas-Jimenez)
| | - Jorge Perales-Oliva
- Gastroenterology Department, Medica Sur Clinic and Foundation, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Jorge Perales-Oliva)
| | - José Vargas-Jimenez
- Department of Gastroenterology and Digestive Endoscopy, Hospital Calderón Guardia/Clínica Biblíca, San José Costa Rica (Alvaro Villalobos-Garita José Vargas-Jimenez)
| | - Félix Téllez-Ávila
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, USA (Félix Téllez-Ávila)
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Su T, Li C, Song B, Song D, Feng Y. Case report and literature review: Giant retroperitoneal cystic lymphangioma. Front Surg 2023; 10:1074067. [PMID: 36733888 PMCID: PMC9887134 DOI: 10.3389/fsurg.2023.1074067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Background Cystic lymphangioma is a rare benign tumor of the lymphatic system, which is most commonly observed in the neck, head and armpit.Less than 5% of lymphangiomas occur in the abdominal cavity and even less in the retroperitoneum. Case description A 65-year-old male patient was diagnosed with an "abdominal mass that had persisted for 1 year, accompanied by abdominal pain, abdominal distension and dyspnea for 7 days". After abdominal computerd tomography, a giant multilobed abdominal lymphangioma was suspected, which squeezed the intestinal canal and was closely related to the inferior vena cava. The patient underwent an exploratory laparotomy, during which, it was found that the tumor formed extensive adhesions to the transverse colon, small intestine and pelvic wall, and enveloped the abdominal aorta, superior mesenteric artery, inferior mesenteric artery and inferior vena cava to varying degrees. It was diffcult to remove the cyst completely. Postoperative pathology confirmed the diagnosis of retroperitoneal cystic lymphangioma. The patient recovered well after the operation, was eating normally by 5 days postoperatively,and was discharged 10 days postoperatively.The patient was followed up 1 month after postoperatively and no evidence of recurrence was observed. Conclusion In this case, we report a patient with giant retroperitoneal cystic lymphangioma who underwent exploratory laparotomy combined with preoperative abdominal computerd tomography and acute abdominal pain, abdominal distension and dyspnea. Because of the large volume of the tumor and its close relationship with the superior mesenteric artery and other blood vessels, the surgeon used scissors to separate the tumor sharply and removed the whole tumor completely.
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Affiliation(s)
- Tieshan Su
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Chaoyuan Li
- Departments of Orthopedics Surgery, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Bin Song
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Defeng Song
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China,Correspondence: Defeng Song Ye Feng
| | - Ye Feng
- Departments of Gastrointestinal Colorectal Anus Surgery, China-Japan Union Hospital, Jilin University, Changchun, China,Correspondence: Defeng Song Ye Feng
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Ray R, Baruah TD, Mahobia HS, Borkar A. Pancreatic Lymphangioma: An Unusual Cause of Abdominal Lump. Cureus 2021; 13:e19452. [PMID: 34926026 PMCID: PMC8654082 DOI: 10.7759/cureus.19452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 11/11/2022] Open
Abstract
Lymphangiomas are uncommon benign malformations that can occur anywhere in the body. These are hamartomatous malformations with lymphatic differentiation, which uncommonly involve the abdomen and rarely the pancreas. The size of the cysts in pancreatic lymphangioma directly correlates with the clinical manifestations; however, most of them are non-specific. Preoperative diagnosis is challenging because conventional imaging examinations like an abdominal ultrasonogram (USG), computed tomography, or magnetic resonance imaging cannot distinguish pseudocyst, mucinous cyst neoplasms, simple cyst, intraductal papillary mucinous neoplasms, and serous cystadenoma. We are presenting a rare case of pancreatic lymphangioma where the definitive diagnosis was made postoperatively in histopathological examination. A female patient aged 27 years presented to the Surgery outpatient department with a slow-growing abdominal lump of 9 months duration. Clinical examination revealed large, non-tender, soft cystic swelling occupying the entire upper abdomen. Radiological imaging showed a large multiseptated cystic lesion occupying almost the entire abdomen and adhered to the pancreas with mass effect. USG-guided fine-needle aspiration revealed straw-colored aspirate with mature lymphocytes. On exploration, there was a large multiloculated cyst occupying the whole abdomen. Cysts were decompressed, and the entire lesion was excised. Final histopathological examination showed unremarkable pancreatic tissue with attached lesion consisting of dilated lymphatic spaces with lymphatic follicles.
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Affiliation(s)
- Rubik Ray
- General Surgery, All India Institute of Medical Sciences, Raipur, IND
| | | | | | - Akshay Borkar
- General Surgery, All India Institute of Medical Sciences, Raipur, IND
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Bono GM, Maneiro LE, Martínez JE. [Minimally invasive approach for the treatment of Giant retroperitoneal cystic tumors: Presentation of two cases and literature review]. REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS 2021. [PMID: 34617699 PMCID: PMC8760920 DOI: 10.3105310.31053/1853.0605.v78.n3.32759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The primary retroperitoneal tumors are malignant or no malignant neoplasias, which the mesenteric cyst has an uncommon presentation. They have a great histological variety that includes the simple lymphatic cysts or the lymphangiomas which are congenital or acquired tumors whose intra-abdominal localization is unusual. There are three clinical features: incidental, unspecific and acute; and their therapeutic management is determinate by their radiological profile and it involves the preoperative percutaneous drainage in case of huge cysts for decreasing the size of the tumor and getting the radical cystectomy without relapse. This review presents two cases of acute abdominal pain related to huge retroperitoneal cysts resolved by minimally invasive approach and bibliographic review.
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Affiliation(s)
- Gonzalo Matías Bono
- Instituto Medico Rio Cuarto
Hipólito Yrigoyen 1020. Rio Cuarto, Córdoba, Argentina. 5800
Rio CuartoCórdobaArgentina
| | - Luis Eduardo Maneiro
- Instituto Medico Rio Cuarto
Hipólito Yrigoyen 1020. Rio Cuarto, Córdoba, Argentina. 5800
Rio CuartoCórdobaArgentina
| | - José Esteban Martínez
- Instituto Medico Rio Cuarto
Hipólito Yrigoyen 1020. Rio Cuarto, Córdoba, Argentina. 5800
Rio CuartoCórdobaArgentina
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Kodera K, Abe K, Kanehira M, Futagawa Y, Okamoto T, Ikegami T. Retroperitoneal lymphangioma mimicking malignant tumor treated by pancreaticoduodenectomy. Clin J Gastroenterol 2021; 14:1791-1797. [PMID: 34386941 DOI: 10.1007/s12328-021-01492-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
Lymphangiomas are classified as lymphatic malformations, which are more common in children and rare in adults. It frequently occurs in the cervical and axillary regions and uncommonly in the retroperitoneum. A 39-year-old woman presented to our department for the investigation for a 55 mm asymptomatic mass in the right anterior adrenal cavity. Abdominal ultrasound showed a tumor containing cysts in the right anterior adrenal cavity. Contrast-enhanced computed tomography showed that the tumor was poorly contrasted and ill-defined. Magnetic resonance imaging suggested that the tumor contained a small amount of fat. The tumor tended to grow, and the possibility of malignant diseases such as liposarcoma could not be excluded. Therefore, surgical resection was performed. Since intraoperative findings showed that the tumor tightly invaded to the duodenum and pancreatic head, a pancreaticoduodenectomy was selected. The entire tumor was removed without exposing the tumor. Macroscopic findings indicated that the specimen was 55 mm in size, indistinctly demarcated, yellow-white in color, and polycystic. Histologically, lymphovascular proliferation was observed with infiltration of the pancreatic head and the duodenal muscle layer. The diagnosis of lymphangioma was finally made. There was no recurrence 2 years after surgery.
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Affiliation(s)
- Keita Kodera
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Kyohei Abe
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan.
| | - Masaru Kanehira
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Yasuro Futagawa
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Tomoyoshi Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
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8
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Pérez Fernández A, Alcaraz Mateos E, López Martín A. A rare cause of intra-abdominal cysts: pancreatic cystic lymphangiomas. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 113:682. [PMID: 33393336 DOI: 10.17235/reed.2020.7671/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Echenique et al. described a lymphangioma as a rare cystic neoplasm of the pancreas. We present a similar intra-abdominal lesion diagnosed by endoscopic ultrasound (EUS)-fine-needle aspiration (FNA) cytology.
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9
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Anbardar MH, Soleimani N, Aminzadeh Vahedi A, Malek-Hosseini SA. Large cystic lymphangioma of pancreas mimicking mucinous neoplasm: case report with a review of histological differential diagnosis. Int Med Case Rep J 2019; 12:297-301. [PMID: 31564993 PMCID: PMC6731960 DOI: 10.2147/imcrj.s218056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/24/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose Cystic lymphangioma of the pancreas was first recognized in 1913 as a form of benign cyst. It is extremely rare, accounting for less than 1% of the lymphangiomas. Case report Herein, we report a case of cystic pancreatic lymphangioma diagnosed in a 51-year-old female patient who was hospitalized for a colicky upper abdominal pain for a month. Radiological imaging revealed a large multiloculated cystic pancreatic mass with enhancing septations. The patient underwent distal pancreatectomy, and the histological examination showed cystic lymphangioma. Conclusion Although very uncommon, cystic lymphangioma should be placed in the differential diagnosis list of pancreatic cystic lesions, at least about the multi-septated ones in asymptomatic female patients which are discovered incidentally.
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Affiliation(s)
- Mohammad Hossein Anbardar
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Soleimani
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arian Aminzadeh Vahedi
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Malek-Hosseini
- Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Surgery, Abualisina Hospital, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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Viscosi F, Fleres F, Mazzeo C, Vulcano I, Cucinotta E. Cystic lymphangioma of the pancreas: a hard diagnostic challenge between pancreatic cystic lesions-review of recent literature. Gland Surg 2018; 7:487-492. [PMID: 30505770 DOI: 10.21037/gs.2018.04.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Lymphangiomas are rare congenital benign tumors arising from the lymphatic system. The incidence of this disease in the pancreas is extremely rare, accounting for less than 1% of these tumors. Before introducing the review we reported a case of a 67-year-old woman with cystic lymphangioma of the pancreas. We reported the radiological investigations carried out preoperatively and the treatment performed. The review tries to identify the features described in literature of the pancreatic lymphangioma. We have performed a PubMed research of the world literature between January 1st 2000, to November 31st 2017, using the keywords [Lymphangioma pancreas], [diagnosis], [CT lymphangioma] and [MRI lymphangioma]. We have found 158 articles, of which about 100 were case reports. Based on our search criteria, we have identified 31 pancreatic lymphangioma in literature reporting their imaging characteristics. According to our report and to several authors in literature the diagnosis of cystic pancreatic lymphangioma should be considered as a differential diagnosis of pancreatic cystic lesions (PCLs). The role of imaging exams (CT and MRI) can help to identify and suspect this possibility of diagnosis. The endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) can have a potential role to reach the correct diagnosis.
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Affiliation(s)
- Francesca Viscosi
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Section of General Surgery, University of Messina, Messina, Italy
| | - Francesco Fleres
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Section of General Surgery, University of Messina, Messina, Italy
| | - Carmelo Mazzeo
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Section of General Surgery, University of Messina, Messina, Italy
| | - Ignazio Vulcano
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Section of General Surgery, University of Messina, Messina, Italy
| | - Eugenio Cucinotta
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Section of General Surgery, University of Messina, Messina, Italy
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Lu G, Li H, Li Y. Lymphangiomatosis of the sigmoid colon - a rare cause of lower gastrointestinal bleeding: A case report and review of the literature. Oncol Lett 2016; 13:339-341. [PMID: 28123564 DOI: 10.3892/ol.2016.5399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/20/2016] [Indexed: 12/29/2022] Open
Abstract
The present study reports the case of a 79-year-old Chinese man who presented to The First Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) for the treatment of lower gastrointestinal bleeding. Multiple cystic masses in the sigmoid colon were observed with colonoscopy, and through endoscopic ultrasound (EUS), these cystic masses were confirmed to be echo-free and to exhibit septal walls in the submucosal layer; in consequence, lymphangiomatosis of the sigmoid colon was diagnosed. Considering the repeated bleeding, laparoscopy-assisted partial sigmoid colon resection was performed. The excised specimens were multiple vesicular and soft masses of ~1 cm in diameter, which were located in the submucosal layer and were surrounded by flat endothelial cells. Immunohistochemistry revealed that the specimens were positive for the specific lymphatic endothelial marker D2-40. The pathological diagnosis was consistent with the EUS findings. In the 2-year follow-up after the operation, no bleeding or other complications were noticed.
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Affiliation(s)
- Guifang Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Hongxia Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Yuanyuan Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
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Rana SS, Chhabra P, Sharma V, Pervez N, Sharma R, Srinivasan R, Bhasin DK. Disseminated lymphangiomatosis presenting as chylous ascites and diagnosed with endoscopic ultrasound. Endosc Ultrasound 2016; 5:210-1. [PMID: 27386481 PMCID: PMC4918307 DOI: 10.4103/2303-9027.183974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Surinder Singh Rana
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Puneet Chhabra
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishal Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nadeem Pervez
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravi Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Kumar Bhasin
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Sato T, Matsuo Y, Shiga K, Saito K, Morimoto M, Miyai H, Takeyama H. Laparoscopic resection of retroperitoneal lymphangioma around the pancreas: a case report and review of the literature. J Med Case Rep 2015; 9:279. [PMID: 26651336 PMCID: PMC4675055 DOI: 10.1186/s13256-015-0760-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/05/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Lymphangiomas are rare, benign tumors. An intra-abdominal location of these lesions is rarer still and there are only a few reports describing laparoscopic resection for retroperitoneal lymphangiomas, especially in tumors that mimic pancreatic tumors. CASE PRESENTATION We present the case of an asymptomatic 30-year-old Japanese woman in whom a cystic tumor was found incidentally in close approximation to the pancreas. Because the tumor was located in the retroperitoneal space and the body of the pancreas was compressed, we were unable to distinguish a cystic lymphangioma from cystic pancreatic tumors. We started the procedure laparoscopically with five ports. The tumor was in fact separated from the pancreas and was dissected free from the body of the pancreas using scissors and laparoscopic coagulating shears. The left gastric vessels, which were compressed by the tumor, were preserved. As we realized that the tumor was connected to the retroperitoneal lymphatic tissue, we completed the procedure by performing a cystectomy without rupture. The specimen was extracted using a plastic bag. Our patient was discharged on postoperative day 7 without any complications. There is no evidence of recurrence during a >2-year observation period. CONCLUSIONS In addition to the therapeutic significance in differentiating between a cystic lymphangioma in close approximation to the body of the pancreas and a pancreatic cystic neoplasm, the laparoscopic approach is feasible and effective.
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Affiliation(s)
- Takafumi Sato
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Yoichi Matsuo
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Kazuyoshi Shiga
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Kenta Saito
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Mamoru Morimoto
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Hirotaka Miyai
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Hiromitsu Takeyama
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
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Allaei A, Lang EK. Retroperitoneal Hygroma. Int Braz J Urol 2015. [PMID: 26200558 PMCID: PMC4752158 DOI: 10.1590/s1677-5538.ibju.2014.0488] [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] [Indexed: 11/21/2022] Open
Abstract
We present a 46-year-old white male with a retroperitoneal hygroma protruding from the right flank.
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Affiliation(s)
- Atabak Allaei
- SUNY Downstate - Kings County Medical Center - Radiology, United States
| | - Erich K. Lang
- Johns Hopkins Medical Institutions - Radiology, United States; Tulane School Medicine - Radiology, United States
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Gao L, Zhang S, Wang H, Qiu Y, Yang L, Yuan J, Wei Q, Han P. Clinical and pathological characteristics of adrenal lymphangioma treated by laparoscopy via a retroperitoneal approach: experience and analysis of 7 cases. Int J Clin Exp Med 2015; 8:4212-4219. [PMID: 26064332 PMCID: PMC4443166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/25/2015] [Indexed: 06/04/2023]
Abstract
To describe the clinical and pathological characteristics of adrenal lymphangioma (AL) and share our experiences of the treatment of AL with retroperitoneal laparoscopic surgery. All patients pathologically diagnosed with AL were examined. The clinical and pathological characteristics, process of diagnosis, and preparation and treatment of all patients, especially patients treated with laparoscopic surgery, were summarized and retrospectively analyzed. From January 2008 to May 2014, 8 patients underwent adrenalectomies and were diagnosed with AL in our hospital. The median age was 45.5 years. All of these patients experienced a smooth adrenalectomy: 7 performed by laparoscopy via a retroperitoneal approach and 1 performed by open surgery. Five were female and the other 3 were male. These patients had unilateral adrenal lesions. Four were located on the right which to be same as the contralateral. In addition, 1 specimen was assayed by immunohistochemistry (IHC), which revealed positive results for CD31, CD34, Factor VIII-related antigen and D2-40, and negative results for cytokeratin AE1/AE3. During a brief follow up, all patients exhibited favorable results without discomfort. AL is a benign lesion with mild bio-behavior and patients are generally asymptomatic. The use of computerized tomography (CT) combined with enhanced CT has a superior advantage in diagnosis. Laparoscopic adrenalectomies that are performed via a retroperitoneal approach would be a very safe and efficient choice for AL treatment. D2-40 can be considered as a specific IHC marker in the pathological diagnosis of AL. However, pheochromocytoma and adrenal tuberculosis should be ruled out before and during the operation.
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Affiliation(s)
- Liang Gao
- Department of Urology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Shu Zhang
- Department of Emergency, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Huan Wang
- Department of Pathology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Yan Qiu
- Department of Pathology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Lu Yang
- Department of Urology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Jiuhong Yuan
- Department of Urology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
| | - Ping Han
- Department of Urology, West China Hospital, Sichuan UniversityNo. 37 Guoxue Xiang, Chengdu 610041, China
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