Presentation
Nausea, vomiting, abdominal pain.
Patient Data
Diffusely dilated small bowel. Gradual dilution of oral contrast through obstructed bowel.
Transition point at intussusception in the central pelvis leading into a short segmental of irregular fluid-density mass.
Case Discussion
Small bowel lymphangiomas have been rarely reported. In this case, it served as the lead point for intussusception, resulting in small bowel obstruction.
Pathology report:
FINAL DIAGNOSIS: Small bowel mass - Features consistent with a lymphangioma.
CLINICAL HISTORY: 25 year old female with tumor in small bowel causing
intussusception, resection done.
GROSS DESCRIPTION: Single fragment. Dimensions - 14.5 x 7 cm; There is attached mesentery 8x3.5cm. Bowel previously opened exposing the mucosa around the site of the tumor. Small bowel, tan colored, fungating mass with multiple small cysts of 5cm from margin I, 7.2cm from margin II, 4.5cm from radial margin. Mass is soft and spongy to touch and circumferential obstructing the lumen of the bowel, measures 6.5 x 5 x 5 cm. The serosal surface and mucosa are largely unremarkable. There is no gross perforation seen.
MICROSCOPIC DESCRIPTION: Sections show tissue fragments from the small bowel with a lesion composed of distended lymphatic channels with interspersed congested blood vessels surrounded by loose connective tissue extending through the lamina propria, submucosa and subserosa and parts of the mesentery. Minimal lymphoid cells are seen in the periphery of the lesion. No atypia is seen within the lesion and no dysplasia within the small bowel epithelium.
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