Mesenteric cystic lymphangioma with myxoid degeneration: Unusual CT and MR manifestations

Abstract

We report an unusual case of mesenteric cystic lymphangioma presenting as a large multilocular mass with a well-enhanced solid component and a central cleft, which were were pathologically correlated to the prominent stromal myxoid degeneration interspersed with abundant capillaries and the central fibrosis, respectively. The findings of computed tomography and magnetic resonance imaging are illustrated. Recognition of the multilocular configuration of the enhanced stroma may help to make the correct preoperative diagnosis.

Cavernous mesenteric lymphangioma (2006: 4b)

“…Intra-abdominal lymphangioma is very rare and comprises less than 5% of all lymphangiomas, about 60% occurring in patients under the age of 5 years [3]. The etiology of lymphangioma is poorly understood but is generally believed to be a developmental abnormality associated with failure of the developing lymphatic tissues to establish normal communication with regional lymphatic drainage, resulting in dilatation of the abnormal channels [4]. Lymphangiomas are classified as simple capillary, cavernous and cystic types, depending on the size of the lymphatic spaces and the nature of the lymphatic wall [1,4].…”

“…The etiology of lymphangioma is poorly understood but is generally believed to be a developmental abnormality associated with failure of the developing lymphatic tissues to establish normal communication with regional lymphatic drainage, resulting in dilatation of the abnormal channels [4]. Lymphangiomas are classified as simple capillary, cavernous and cystic types, depending on the size of the lymphatic spaces and the nature of the lymphatic wall [1,4]. Intra-abdominal lymphangioma is mainly the cystic form, composed of large macroscopic lymphatic spaces that have no connection with the adjacent lymphatic tissue.…”

Primary mesenteric lymphangioma in a young adult with intestinal malrotation and ‘counter-clockwise barber pole sign’

“…Occasionally, negative attenuation values occur in the presence of chyle. Calcification may occur but is uncommon 12. MDCT with thin slice multiplanar reformation is helpful not only to diagnose the lesion, but also to assess the complications such as volvulus and intestinal obstruction.…”

Abdominal cystic lymphangioma in childhood: report of eight cases

“…Na ressonância nuclear magnética o linfangioma apresenta baixo sinal nas imagens ponderadas em T1 e alto sinal nas imagens ponderadas em T2. Estes dois exames podem ser úteis quando o diagnóstico não está bem estabelecido ou quando se deseja ter uma noção mais exata da relação do linfangioma com estruturas vizinhas 15 .…”

“…A associação com linfangiectasia difusa da parede intestinal adjacente e a degeneração mixóide são alterações descritas e que podem complicar o diagnóstico 15 .…”