Cystic lymphangioma of the stomach with marked reactive changes: a rare cause of gastric outlet obstruction in adult

Nayak, Mamita; Purkait, Suvendu; Sasmal, Prakash Kumar; Singh, Pradip

doi:10.1136/bcr-2019-233582

Cited by 3 publications

(6 citation statements)

References 13 publications

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“…They may be asymptomatic and can be identified incidentally (18.2%, 4/22). Sometimes, they may have various chief complaints, even could cause gastrointestinal hemorrhage [4] , tumor rupture [5] , gastric outlet obstruction [6] or gastric perforation [7] , depending upon the size and location of a tumor. There are only two cases that gastric lymphangioma coexists with mucosal gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

Gastric lymphangioma: a case report and review of literature

et al. 2022

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Background Gastric lymphangioma is one of the highly rare benign tumors characterized by multilocular or unilocular lymphatic spaces. Herein, we report a case of lymphangioma in the gastric antrum. Case presentation A 77-year-old male patient who had been experiencing epigastric discomfort for a year was presented to our hospital. A gastric subepithelial lesion was diagnosed by upper endoscopy and was entirely excised via diatal subtotal gastrectomy. Endoscopic ultrasonography revealed an echoless homogenous echo pattern in the third wall layer. A lymphangioma was diagnosed by pathologic investigation of the resected specimen. The PubMed, Embase and Web of Science databases were reviewed for literature in English while using the keywords of “gastric lymphangioma” or “lymphangioma of stomach” or “gastric lymphatic cyst” or “lymphatic cyst of stomach” and the results were discussed. Conclusion Gastric lymphangioma is a rarely occurring submucosal tumor that should be considered when diagnosing subepithelial lesions in the stomach.

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Section: Discussionmentioning

confidence: 99%

Gastric lymphangioma: a case report and review of literature

et al. 2022

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“…They have a wide range of clinical presentations, ranging from asymptomatic to abdominal pain, nausea/vomiting, and distention [ 1 , 3 - 9 ]. Significant complications of these abdominal lymphatic malformations include obstruction, infection, torsion/volvulus, hemorrhage, rupture, and peritonitis [ 5 , 10 - 12 ]. Pediatric patients with abdominal lymphatic malformations tend to present with more acute symptoms as opposed to adults, who tend to be either asymptomatic or present with chronic symptoms [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…He presented with gastric outlet obstruction, and imaging studies found a posterior antral mass, but FNA identified spindle cells. An oncologic gastric resection was performed, and pathology also revealed lymphatic malformation with fibroblastic and myofibroblastic proliferation [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Tumor or Inflammatory Myofibroblastic Reaction in an Adolescent With an Abdominal Lymphatic Malformation?

Lee¹,

Ignacio²,

Vicente³

et al. 2022

Cureus

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We report the case of a 17-year-old male who presented with intractable nausea and vomiting. Cross-sectional imaging revealed a large retrogastric abdominal mass. Fine needle aspiration done via endoscopic ultrasound (EUS) was nondiagnostic. Exploratory laparotomy revealed a large inflammatory mass densely adherent to the stomach and retroperitoneum. Incisional biopsy frozen section revealed spindle cells, and subsequent resection of the mass with en-bloc subtotal gastrectomy with Roux-en-y gastrojejunostomy reconstruction was performed. Final pathology demonstrated a lymphatic malformation with reactive myofibroblastic proliferation. Inflammatory abdominal lymphatic malformations are especially rare and not well described in the literature. These masses may present diagnostic challenges until the specimen is sent for pathologic analysis.

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“…In recent years, with the wide application of EUS which could provide valuable information, EUS became one of the most important diagnostic modalities for vascular tumors arising from the gastrointestinal tract ( 11 , 24 ). However, the EUS features of gastric lymphangioma are not well demonstrated, possibly owing to its rarity ( 26 ). In endoscopy, most UGLs are recognized as polyps, and EUS is used to confirm the size and origin of the lesion ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is extremely challenging for the diagnosis of relatively small gastrointestinal lymphangiomas, and histological examination is essential for a definitive diagnosis (26).Margaret et al reported that it was hard to distinguish lymphangioma because of the histologic overlap with lymphangiectasia of the gastrointestinal mucosa (31). Compared with lymphangiectasia, he demonstrated the most reliable histologic features of lymphangioma as the presence of smooth muscle surrounding the lymphatic spaces and complete circumferential lining of spaces by endothelial-type cells (31, 32).…”

Section: Lesions and 5 Patients With Middle-esophageal Lesions In All 14mentioning

confidence: 99%

Endoscopic resection of upper gastrointestinal lymphangioma: A single-center experience

Shi

Xue

et al. 2022

Front. Oncol.

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ObjectiveLymphagioma, which in most cases as benign tumors, occurs in head, neck, axilla, and mediastinum. Lymphangioma is exceedingly rare in the upper gastrointestinal tract including esophagus, stomach, and duodenum. However, the clinical characteristics, natural history, and recurrence rate after endoscopic resection remain unclear. This study aims to evaluate the characteristic findings and assess the efficacy of endoscopic techniques in the management of this disease.MethodsIn this systematic retrospective analysis, we evaluated all 24 cases of upper gastrointestinal lymphangioma resected by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) and diagnosed by histopathology at our hospital from January 2012 to May 2021. We analyzed the results of endoscopy, endoscopic ultrasonography (EUS), CT, histologic examination, and follow-up assessments.Results9 male and 15 female patients with esophageal lymphangioma were enrolled in this study, with a mean age of 54.17 ± 11.60 years (range 30-71 years). The lesions’ size varied from 2.20 to 40.10 mm, with the median size of 7.83 mm. All patients were evaluated preoperatively, whose endoscopic appearance typically appears as dilated lymphatic channels beneath the surface epithelium of the protrude mucosal or sub-mucosal lesion. Endoscopic ultrasonography revealed the presence of a honeycomb-like or grid-like mass with a heterogeneous echo pattern, and a clear boundary between the lesion and the muscularis propria layer may be helpful for the primary diagnosis of this disease. 22 patients underwent EMR and 2 patient were treated with ESD. Histologic examination revealed that the lesions contained many dilated lymphatic vessels, which confirmed the initial diagnosis of lymphangioma in all patients. No major adverse events were found during the operation or a median follow-up of 43 months (range 13–92).ConclusionsEndoscopic ultrasonography has important clinical value for the primary diagnosis of lymphangioma in the upper gastrointestinal tract. This study also suggests that endoscopic resection should be considered as a more minimally invasive, safe, feasible, and effective therapeutic option comparing to laparoscopic surgery.

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Cystic lymphangioma of the stomach with marked reactive changes: a rare cause of gastric outlet obstruction in adult

Cited by 3 publications

References 13 publications

Gastric lymphangioma: a case report and review of literature

Gastric lymphangioma: a case report and review of literature

Tumor or Inflammatory Myofibroblastic Reaction in an Adolescent With an Abdominal Lymphatic Malformation?

Endoscopic resection of upper gastrointestinal lymphangioma: A single-center experience

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