Cystic lymphangioma of the pancreas mimicking pancreatic pseudocyst

Abstract

Lymphangiomas are rare congenital benign tumors arising from the lymphatic system, and are mostly encountered in the neck and axillary regions of pediatric patients (95%). Lymphangioma of the pancreas is extremely rare accounting for less than 1% of these tumors. We report here on a case of pancreatic cystic lymphangioma. A 54-year-old woman presented with intermittent postprandial abdominal discomfort and radiating back pain. Abdominal computed tomography scan revealed 8 × 6.5 cm hypodense cystic mass arising from the tail of the pancreas without septa or solid component. The initial impression was a pancreatic pseudocyst. The patient underwent distal pancreatectomy with splenectomy. The histopathologic and immunohistochemical study helped make the diagnosis of a pancreatic cystic lymphangioma. Herein, we report a case of pancreatic cystic lymphangioma mimicking pancreatic pseudocyst and review the relevant medical literature.

Rare Case of Pancreatic Cystic Lymphangioma

“…Histologically, pancreatic cystic lymphangiomas consist of interconnecting cysts separated by thin septa lined by thin and flat epithelial cells containing serous, serosanguineous, or chylous fluid ( 22 , 23 ). Immunohistochemistry can be used to increase the accuracy of the diagnosis.…”

Rare Nonneoplastic Cysts of Pancreas

“… 48 Although the pathogenesis of lymphangiomas is still unclear, a well-established theory suggests that lymphangiomas arise from sequestrations of lymphatic tissue during embryonic development. 49 However, it has been suggested that abdominal trauma, lymphatic obstruction, inflammatory processes, surgery or radiation therapy lead to the secondary formation of lymphangiomas. 50 A diagnosis of pancreatic cystic lymphangioma is made if the aspirated fluid is chylous in appearance and has an elevated triglyceride level.…”

Abdominal Distention and Early Satiety, Pancreaticoduodenectomy for Lymphangioma

“…2 The recommended treatment for symptomatic tumors is excision of the complete tumor to ensure the lack of recurrence. 4 As a result of the involvement of our patient's tumor with the pancreas and surrounding structures, a PD was performed, which successfully removed the entire tumor.…”