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Mesenteric cystic lymphangioma

Case contributed by Jennifer Richardson Maturana
Diagnosis certain

Presentation

1-year history of abdominal distension

Patient Data

Age: 3 years
Gender: Female

Large cystic abdominal lesion demonstrating multiple septae. The lesion is encapsulated, which loses the cleavage planes with the greater omentum on its anterior face with diameters greater than 20 x 17 x 8 cm and 10 HU on average with a slight enhancement of the capsule is 0.1 cm thick. It has a mass effect on all intestinal structures, pancreas and compresses the gallbladder.

pathology

Intraoperative photograph demonstrating a septated cystic mass.

pathology

Histology shows mixed inflammatory infiltrate and lymphoid clusters with ectatic lymphatic vessels.

Case Discussion

Lymphangioma is generally asymptomatic, however, it can present as abdominal distension as in this case. The diagnostic imaging approach by tomography allows characterizing a cystic mass circumscribed in the mesenteric plane with variable density. It is the most appropriate method to establish the diagnosis by allowing to differentiate between benign and malignant causes, as well as to perform surgical planning.

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