Solitary hepatic lymphangioma: Report of a case

Abstract

A 52-year-old woman presented with upper abdominal pain. Abdominal ultrasonography showed a 4-cm well-defined mass containing solid and cystic components in segment IV of the liver, and contrast-enhanced T1-weighted magnetic resonance imaging revealed heterogeneous enhancement within the tumor, indicating a solid or fibrous component. There were no cystic lesions in any other organs. A partial hepatectomy was performed, based on a preoperative diagnosis of sclerosing hemangioma and biliary cystadenoma or cystadenocarcinoma. Pathologically, the tumor appeared to be a multilocular and cystic lesion lined by attenuated endothelial- like cells with no atypia. Immunohistochemistry demonstrated the endothelial-like cells to be positive for the lymphatic-specific markers D2-40, LYVE-1, and Prox-1, which proved helpful for confirming the diagnosis as solitary hepatic lymphangioma. This case is presented with details of the pathologic and radiologic findings, because solitary hepatic lymphangioma is an extremely rare tumor and no previous reports have provided details of the immunohistochemical characteristics.

A rare case of liver lymphangioma

“…1,12 Others have been described as containing solid or fibrous components. 13 Calcification, as seen in our case, is rare but has also been documented. 1 Prior to histological analysis, and in view of the history of breast cancer, the lymphangioma in this case was suspected of being metastatic.…”

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

“…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 ].…”

“…Lymphangiomas are rare benign masses characterized by dilated lymphatic vessels, usually resulting from blockade of lymphatic reflux or abnormal development of the lymphatic system in embryogenesis[ 1 - 4 ]. The lymphatic system and venous system lack communication, which leads to the malformation of lymphatics.…”

“…Lymphangioma is significantly associated with chromosome abnormalities, including chromosome X abnormalities (Turner syndrome), trisomy 21 (Down syndrome), trisomy 18, trisomy 13, and triploidy, copy number variants, and genetic mutations such as AKT1 , PIK3CA , VEGFR3 , and RASA1 [ 5 - 8 ]. It is reported that lymphangiomas are more common in neonates and children compared to adults[ 1 , 9 ].…”

Solitary hepatic lymphangioma: a one-case report

“…Hepatic lymphangiomas usually have non-specific clinical signs or symptoms (Matsumoto et al 2010; Allen et al 2006). In our case, the main complaint of patient was left upper abdominal pain, which may be related to the expansion of the giant lesion compressing the surrounding structures.…”