Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2024.470
Autopsy and Case Reports
Clinical Case Report

Mesenteric cystic lymphangioma in adults: a rare entity presenting as acute abdomen - a report of two cases

Tanvi Jha; Monika Sharma; Arvind Ahuja

Downloads: 2
Views: 356

Abstract

Lymphangiomas are rare benign tumors that mainly involve the head and neck region in pediatric patients. Lymphangiomas of the small bowel mesentery in adults are rarer. We present two cases of mesenteric lymphangioma with acute abdominal pain on presentation. Case 1: A 38-year-old female presented with abdominal pain, vomiting, fever, and difficult evacuation. On abdominal examination, she had an ill-defined, tender lump, and radiological findings raised a possibility of perforation peritonitis. Thus, exploratory laparotomy was planned. Per-operatively, a mesenteric mass was found, which, on histopathological evaluation, was found to be a mesenteric lymphangioma involving the bowel. Case 2: A 27-year-old male presented with abdominal pain and difficult evacuation. Radiological evaluation revealed a multilobulated lesion involving the mesentery and with differential diagnoses of mesenteric fibromatoses and inflammatory pseudotumor. Histopathological assessment of the resected mass revealed a lymphangioma that was limited to the mesentery. Owing to their rarity and non-specific presentation, mesenteric lymphangiomas are often misdiagnosed on clinical examination and imaging. Thus, histopathological examination is the gold standard to reach a definitive diagnosis.

Keywords

Abdomen, Acute, Adult, Lymphangioma, Mesentery, Lymphatics

References

1 Chen CW, Hsu SD, Lin CH, et al. Cystic lymphangioma of the jejunal mesentery in an adult: a case report. World J Gastroenterol. 2005;11(32):5084-6. http://dx.doi.org/10.3748/wjg.v11.i32.5084. PMid:16124074.

2 Suthiwartnarueput W, Kiatipunsodsai S, Kwankua A, Chaumrattanakul U. Lymphangioma of the small bowel mesentery: a case report and review of the literature. World J Gastroenterol. 2012;18(43):6328-32. http://dx.doi.org/10.3748/wjg.v18.i43.6328. PMid:23180956.

3 Jang JH, Lee SL, Ku YM, An CH, Chang ED. Small bowel volvulus induced by mesenteric lymphangioma in an adult: a case report. Korean J Radiol. 2009;10(3):319-22. http://dx.doi.org/10.3348/kjr.2009.10.3.319. PMid:19412523.

4 Kumar B, Bhatnagar A, Upadhyaya VD, Gangopadhyay AN. Small intestinal lymphangioma presenting as an acute abdomen with relevant review of literature. J Clin Diagn Res. 2017;11(6):PD01-02. http://dx.doi.org/10.7860/JCDR/2017/22703.9962. PMid:28764241.

5 Chen J, Du L, Wang DR. Experience in the diagnosis and treatment of mesenteric lymphangioma in adults: a case report and review of literature. World J Gastrointest Oncol. 2018;10(12):522-7. http://dx.doi.org/10.4251/wjgo.v10.i12.522. PMid:30595806.

6 Rosai J, Ackerman LV. Rosai and Ackerman’s surgical pathology. 9th ed. Edinburgh:Mosby; 2004. Vol. 2; p. 2375-76.

7 Campbell WJ, Irwin ST, Biggart JD. Benign lymphangioma of the jejunal mesentery: an unusual cause of small bowel obstruction. Gut. 1991;32(12):1568. http://dx.doi.org/10.1136/gut.32.12.1568. PMid:1773970.

8 Seki H, Ueda T, Kasuya T, Kotanagi H, Tamura T. Lymphangioma of the jejunum and mesentery presenting with acute abdomen in an adult. J Gastroenterol. 1998;33(1):107-11. http://dx.doi.org/10.1007/s005350050053. PMid:9497231.

9 Rieker RJ, Quentmeier A, Weiss C, et al. Cystic lymphangioma of the small-bowel mesentery: case report and a review of the literature. Pathol Oncol Res. 2000;6(2):146-8. http://dx.doi.org/10.1007/BF03032366. PMid:10936792.

10 Mohammed AA, Musa DH. Lymphangioma of the ileum causing acute abdominal pain in an adult, a very rare finding during surgery: case report with literature review. Int J Surg Case Rep. 2020;66:319-21. http://dx.doi.org/10.1016/j.ijscr.2019.12.031. PMid:31901559.

11 Aprea G, Guida F, Canfora A, et al. Mesenteric cystic lymphangioma in adult: a case series and review of the literature. BMC Surg. 2013;13(Suppl. 1):A4. http://dx.doi.org/10.1186/1471-2482-13-S1-A4.

12 Nagano H, Kimura T, Iida A, Togawa T, Goi T, Sato Y. Cystic lymphangioma in the peripheral jejunal mesentery in an adult and excision with laparoscopic-assisted surgery: a case report. World J Surg Oncol. 2019;17(1):170. http://dx.doi.org/10.1186/s12957-019-1713-6. PMid:31651341.

13 Mabrouk MY, Magouri O, Madani A, et al. Mesenteric cystic lymphangioma in an adult: an unusual case report. Ann Med Surg. 2022;78:103917. http://dx.doi.org/10.1016/j.amsu.2022.103917. PMid:35734669.

14 Abdulraheem AK, Al Sharie AH, Al Shalakhti MH, Alayoub SY, Al-Domaidat HM, El-Qawasmeh AE. Mesenteric cystic lymphangioma: a case report. Int J Surg Case Rep. 2021;80:105659. http://dx.doi.org/10.1016/j.ijscr.2021.105659. PMid:33636409.
 


Submitted date:
12/03/2023

Accepted date:
01/08/2024

Publication date:
02/08/2024

65c4be0ba9539568f1557014 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections