Pancreatic lymphangioma

Pancreatic lymphangiomas are benign lesions that are often found incidentally during cross-sectional imaging for another reason.

More common in adults (in contrast to lymphangiomas in the head and neck, which are more common in children). Account for approximately 1% of abdominal lymphangiomas. More common in women

Lymphangiomas are thought to arise from a congenital blockage of regional lymphatic ducts. They can be pancreatic or peripancreatic.

They may contain serous, serosanguinous, or chylous fluid. Cyst walls are lines with endothelial cells (immunoreactive with VIII-R AG, CD31, and D2-40; negative for CD34).

CT
  • multilocular and multiseptated (occasionally unilocular)
  • homogeneously hypoattenuating, may be fat attenuation
  • phleboliths may be present
  • they can become quite large
MRI
  • T1: hypointense
  • T2: hyperintense
  • multiseptated, lobulated
US
  • multiple hypoechoic or anechoic cysts
  • contents may be echogenic

None usually necessary, but may be excised if locally invasive.

Endoscopic ultrasound (EUS) with cyst fluid aspiration is probably the best way to confirm a pancreatic lymphangioma (it has an elevated triglyceride level).

A pancreatic lymphangioma should not have any enhancing component. If an enhancing component is present, it is more prudent to consider one of the neoplastic entities on the differential.

Finding fat attenuation in the cystic lesion helps to separate pancreatic lymphangioma from other entities on the differential.

If a lymphangioma becomes secondarily infected, it may be difficult to distinguish it from a more aggressive lesion.


Pancreatic pathology
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Article Information

rID: 42938
Synonyms or Alternate Spellings:
  • Pancreatic lymphangiomas
  • Lymphangioma of the pancreas
  • Lymphangiomas of the pancreas

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