An adult case of lymphangioma of the hepatoduodenal ligament mimicking a hepatic cyst

Kohashi, Toshihiko; Itamoto, Toshiyuki; Matsugu, Yasuhiro; Nishisaka, Takashi; Nakahara, Hiroyuki

doi:10.1186/s40792-016-0280-0

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…The morphology was enough to make the diagnosis for most cases[ 13 , 31 ]. Certainly, lymphatic marker, D2-40 (podoplanin), further confirmed the identification of the disease[ 1 , 19 , 32 ]. In addition, endothelial markers, including von Willebrand factor, CD31, and CD34 and two lymphatic markers, LYVE-1 and Prox-1, are recommended through immunohistochemistry staining when it is difficult to distinguish lymphatic vessels from blood vessels[ 1 ].…”

Section: Discussionmentioning

confidence: 90%

“…Treatments for hepatic lymphangioma include complete resection, partial resection with cleaning cystic fluid, needle aspiration, sclerosing agent injection, liver transplantation, and immunosuppressive drugs for diffused and serious condition[ 11 , 12 , 34 - 36 ]. Partial resection with cleaning cystic fluid and needle aspiration can definitely lead to tumor recurrence[ 32 , 36 ]. The effectiveness of sclerosing agent injection, which is effective for a simple liver cyst, is unknown.…”

Section: Discussionmentioning

confidence: 99%

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Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review

Long¹,

Zhang²,

Cheng³

et al. 2020

WJCC

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BACKGROUND Hepatic lymphangioma, a malformation of the liver lymphatic system, is a rare benign neoplasm and usually coexists with other visceral lymphangiomas. Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy. CASE SUMMARY A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with, including Schistosome japonicum infection and jaundice, and also together with imaging results, which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase. The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation. Finally, the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation. The pathological examination indicated the mass as hepatic lymphangioma. The patient has been followed up for 30 mo without recurrence. To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future, we reviewed the published literature of solitary hepatic lymphangioma for its clinical symptoms, imaging presentation, operative techniques, histology features and prognosis. CONCLUSION Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult. Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review

Long¹,

Zhang²,

Cheng³

et al. 2020

WJCC

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“…Congenital or acquired abnormalities of the lymphatic system are the initiating factors causing development of lymphangiomas. Congenital lymphangiomas form due to blockage of the lymphatic system during fetal development resulting in an improper connection of lymphatic channels to the main lymphatic drainage duct [ 4 ], whereas acquired lymphangioma occurs because of an interruption in a previously normal lymphatic drainage system as a result of surgery, trauma, malignancy, and radiation therapy. The congenital form predominately occurs in young children, with 90% found extra-abdominally, such as in the head, neck, and axilla [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rarely, lymphangioma present with an acute abdomen, which can result from obstruction, perforation, or torsion of the bowel secondary to the large volume of the lymphangioma. In case studies, lymphangiomas have been mistaken for liver hematoma [ 6 ], liver cyst [ 7 ], ovarian cyst [ 8 ], and even metastasis [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Peri-Hilar Cystic Lymphangioma Mimicking a Biliary Cystic Lesion Causing Biliary Obstruction: A Case Report and Literature Review

Naser

Mesropyan

2023

Am J Case Rep

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Patient: Male, 62-year-old Final Diagnosis: Lymphangioma Symptoms: Asymptomatic • incidental finding Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Lymphangiomas are rare and benign malformations of the lymphatic system. The presentation of intra-abdominal lymphangiomas, especially from within the hepatoduodenal ligament, is rare in the adult population. In this report, we examine a lymphangioma within the hepatoduodenal ligament resulting in biliary obstruction. Case Report: A 62-year-old man with surgical history of cholecystectomy presented to the hepatobiliary clinic for a peri-hilar cystic lesion identified on surveillance magnetic resonance imaging (MRI). The patient’s MRI revealed a 5.5-cm cystic lesion at the peri-hilar region, likely arising from the biliary tree, which had been increasing in size and causing biliary dilatation. The patient underwent an endoscopic ultrasound, showing a 4.3×2.2 cm cystic structure likley arising from the cystic duct stump with internal septation. An endoscopic retrograde cholangiopancreatography (ERCP) was performed and demonstrated no communication between the biliary tree and the cystic lesion. Given the uncertain etiology of the lesion and its obstructive nature, the patient was moved to the operating room for a complete excision. A well-encapsulated cystic lesion was identified between the cystic duct and the common hepatic duct, which did not communicate with the biliary tree. Pathology confirmed the diagnosis of lymphangioma with features of vascular channel proliferation in the background of fibrotic stroma and lymphoid aggregates. The vascular channel proliferation demonstrated positive immunohistochemical staining for D2-40. At 3-year follow-up, there was no evidence of post-resection recurrence. Conclusions: This case represents an acquired lymphangioma occurring as a sequela of cholecystectomy, likely caused by interruption of the lymphatic drainage system secondary to surgical manipulation.

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“…Regarding the width of the ligament, we found that there were two periods of accelerated development (4-5 months and 9 monthsnewborns) and a period of slow development (5-8 months). It is worth noting that at some stage of development (6 months), the length of the hepatic-duodenal ligament is even slightly reduced, which can probably be associated with an increase in the adjacent organs -the liver and the duodenum in this period [13][14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Organometric parameters of hepatoduodenal ligament n the perinatal period

Yuzko

Слободян

2019

Rep. of Morph.

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During any surgery, in addition to pathology-related factors, it is necessary to evaluate the individual features of the anatomy of a particular area or complex of organs. The relevance of such data is confirmed by the results of numerous studies that show that half of patients are characterized by certain anatomical variants, including the location of the arteries and biliary tract. The purpose of the work is to establish the peculiarities of the morphometric parameters of the components of the hepatic-duodenal ligament. The study was based on 50 preparations of fetus corpses (4 to 10 months) and 10 newborns without external signs of anatomical abnormalities or congenital malformations. Adequate anatomical methods were used during the study: macropreparation, injection of blood vessels, making topographic anatomical sections, morphometry. Statistical analysis of the obtained data was performed using the licensed program RStudio. During the perinatal period, the length of the hepatic-duodenal ligament was found to increase from 5.224±0.572 mm in fetuses for 4 months to 32.12±1.77 mm in newborns. The chart of change of the average values of its length by months of prenatal development indicates uneven increase of organometric parameters. From 4 to 5 months observed a significant increase in the length of the hepatic-duodenal ligament, while from 5 to 7 months of development observed a period of relative slowdown of its length, and from 5 to 6 months of development even a relative decrease in length. The period from 7 to 10 months determines the period of accelerated growth of ligament. The indices of the width of the hepatic-duodenal ligament in the perinatal period increased from 3.292±0.227 mm in fetus of 4 months to 21.25±0.938 mm in newborns. The width increases are not uniform. The periods of accelerated development (4-5 months and 9 months – newborns) and the period of slow development (5-8 months) were observed. It was proved that there are periods of accelerated and slow development, in which during periods of intensive development, organometric indicators always differed significantly, were smaller than the previous ones and outweighed the following ones respectively (4-5 months and 7-9 months, р˂0.05). Regarding the periods of slow development, the organometric indicators in these periods did not differ significantly (р˃0.05). Therefore, analyzing the dynamics of changes in the morphometric parameters of the components of the hepatic-duodenal ligament, revealed periods of their accelerated and slow growth.

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An adult case of lymphangioma of the hepatoduodenal ligament mimicking a hepatic cyst

Cited by 6 publications

References 15 publications

Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review

Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review

Peri-Hilar Cystic Lymphangioma Mimicking a Biliary Cystic Lesion Causing Biliary Obstruction: A Case Report and Literature Review

Organometric parameters of hepatoduodenal ligament n the perinatal period

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