Vygintas Aliukonis1,2, Marius Lasinskas1, Algirdas Pilvelis1, Audrius Gradauskas1,3. 1. Department of Abdominal Surgery, Clinic of Surgery, Vilnius City Clinical Hospital, Antakalnio 57, LT-10207 Vilnius, Lithuania. 2. Centre for Health Ethics, Law and History, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania. 3. Department of Nursing and Fundamentals of Internal Medicine, Faculty of Medicine, Vilnius University, Antakalnio 57, LT-10207 Vilnius, Lithuania.
Abstract
INTRODUCTION: Both mesenteric cysts and cystic lymphangiomas are scarce and clinically and radiologically almost identical derivatives, but their histological structure is fundamentally different. Case Presentation. A 52-year-old woman was consulted by a surgeon for a derivative felt in her abdomen. The patient said she felt a growing derivative in the abdomen about a month ago. After consulting and testing, a sigmoid colon mesenteric cyst (13 cm × 11 cm × 10 cm) was found. Complete excision of the cyst within healthy tissues was performed through laparotomy. The surgery had no complications. The initial pathological answer was a simple mesothelial cyst (a rare histological finding). However, immunohistochemical tests were performed that showed that diagnosis was mesenteric cystic lymphangioma (ML). Cystic lymphangiomas that have a link to the mesentery have been described less than 200 times. CONCLUSIONS: Final differential diagnosis between different cystic derivatives is possible only based on histopathological examinations. Mesenteric lymphangioma is most common at a very young age, but in rare cases, it also occurs in adults. All clinicians should increase their awareness of the disease.
INTRODUCTION: Both mesenteric cysts and cystic lymphangiomas are scarce and clinically and radiologically almost identical derivatives, but their histological structure is fundamentally different. Case Presentation. A 52-year-old woman was consulted by a surgeon for a derivative felt in her abdomen. The patient said she felt a growing derivative in the abdomen about a month ago. After consulting and testing, a sigmoid colon mesenteric cyst (13 cm × 11 cm × 10 cm) was found. Complete excision of the cyst within healthy tissues was performed through laparotomy. The surgery had no complications. The initial pathological answer was a simple mesothelial cyst (a rare histological finding). However, immunohistochemical tests were performed that showed that diagnosis was mesenteric cystic lymphangioma (ML). Cystic lymphangiomas that have a link to the mesentery have been described less than 200 times. CONCLUSIONS: Final differential diagnosis between different cystic derivatives is possible only based on histopathological examinations. Mesenteric lymphangioma is most common at a very young age, but in rare cases, it also occurs in adults. All clinicians should increase their awareness of the disease.
Authors: Sajeev R Ezhapilli; Courtney Coursey Moreno; William C Small; Krisztina Hanley; Hiroumi D Kitajima; Pardeep K Mittal Journal: J Magn Reson Imaging Date: 2014-07-26 Impact factor: 4.813