Lymphangioma: A Rare Benign Cystic Pancreatic Lesion

Abstract

Pancreatic lesions are more commonly identified nowadays with the widespread use of imaging investigations. Pancreatic lesions are heterogeneous groups of pathologies with different behavior and prognosis. It is quite difficult to differentiate these lesions because of the shared clinical manifestation and the overlapping imaging features of these lesions. We report the case of a 38-year-old woman who presented with a complaint of a 3-month history of epigastric abdominal pain radiating to her back. She reported a gradual increase in the severity of the pain. She described it as sharp in quality and was exacerbated with food intake and was alleviated by oral paracetamol. There was no history of abdominal distension, weight loss, or change in appetite. Apart from asthma, she had no other comorbid conditions or previous surgeries. She was referred to have an abdominal computed tomography scan which showed a large lesion that appears to arise from the head of the pancreas and was cystic with no soft tissue component. The radiological impression was a lymphoepithelial cyst, duplication cyst, pseudocyst from previous acute pancreatitis, lymphangioma, or intraductal papillary mucinous neoplasm. The decision for open surgical removal was decided. The patient underwent laparotomy and the cystic lesion was identified as arising from the pancreatic head. Complete resection of the mass was carried out with no complications. Histopathological examination revealed cystic lesions with the presence of lymphoid cells aggregates peripherally. The lining of the channels was positive for CD31 and was negative for CD34. Such findings conferred the diagnosis of lymphangioma. Lymphangioma is a very rare tumor of the pancreas with non-specific clinical and imaging features. Complete surgical resection of the lesion is the treatment of choice and the prognosis of the tumor is favorable if the tumor was resected completely.