J Korean Surg Soc.  2009 Dec;77(6):434-437. 10.4174/jkss.2009.77.6.434.

Splenic Cavernous Lymphangioma Mimicking Splenic Hemangioma

• Kim HH
• Hur YH
• Park CY
• Koh YS
• Kim JC
• Cho CK
• Kim HJ

• KMID: 1464825
• DOI: http://doi.org/10.4174/jkss.2009.77.6.434

Abstract

Lymphangioma of the spleen is a rare benign neoplasm with clinical manifestations ranging from insignificant incidental findings to large, symptomatic cystic masses requiring surgical intervention. We report a case of splenic cavernous lymphangioma mimicking splenic hemangioma. A 59-year-old woman presented with left upper quadrant pain and epigastric discomfort. Computed tomography showed a 9.5x8 cm high attenuated mass with relatively homogenous enhancement in the spleen. The initial impression was a splenic hemangioma. The patient underwent splenectomy. Gross pathologic examination revealed a 9.5x6.8x9 cm-sized fairly well circumscribed soft mass. Histologically, the tumor was composed of dilated lymphatic vessels, which contained homogenous eosinophilic material. The Final diagnosis was cavernous lymphangioma of the spleen. Herein, we report a case of splenic cavernous lymphangioma mimicking splenic hemangioma and also review the existing literature.

Keyword

Cavernous lymphangioma; Spleen; Hemangioma

MeSH Terms

Caves
Eosinophils
Female
Hemangioma
Humans
Incidental Findings
Lymphangioma
Lymphatic Vessels
Middle Aged
Spleen
Splenectomy

Figure

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  Fig. 1 Abdominal ultrasonography reveals a mild splenomegaly and about 9.2×6.6 cm-sized mixed echoic mass in the spleen.

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  Fig. 2 The abdominal computed tomography (CT) findings. (A) In the arterial phase, CT scan shows a 9.5×8 cm high attenuated mass with relatively homogenous enhancement in the spleen. (B) In the portal pahse, CT scan shows a low attenuated mass with homogenous enhancement of similar degree to normal spleen parenchyma.

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  Fig. 3 Gross findings of splenic cavernous lymphangioma. Gross pathologic examination reveals a 9.5×6.8×9 cm-sized mass composed of various-sized cysts with internal hemorrhage.

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  Fig. 4 Microscopic findings. (A) Histologically, the tumor is composed of dilated lymphatic vessels, and contained homogenous eosinophilic material (H&E stain, ×100). (B) Immunohistochemical finding shows positive endothelial-lined cells in immunostaining by CD 34 (×100).

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