J Korean Med Sci.  2010 Jan;25(1):155-158. 10.3346/jkms.2010.25.1.155.

A Case Report with Lymphangiomatosis of the Colon

• Jung SW
• Cha JM
• Lee JI
• Joo KR
• Choe JW
• Shin HP
• Kim KY

• KMID: 1713849
• DOI: http://doi.org/10.3346/jkms.2010.25.1.155

Abstract

The incidence of lymphangiomas in the gastrointestinal tract is low, particularly in the colon and rectum, and most cases are solitary. Lymphangiomatosis of the colon are encountered infrequently with only one report in the English literature, and polypectomy was performed for the diagnosis in that case report. However, trends in the diagnosis of lymphangiomatosis of colon have been changing since the development of endoscopic ultrasonography (EUS), and this case is the first in that lymphangiomatosis of the colon was diagnosed without invasive procedures. Here we describe the case of 31-yr-old woman with lymphangiomatosis of the colon with numerous polyposis-like appearing lesions diagnosed by endoscopic ultrasonography and a colonoscopy.

Keyword

Colon; Endosonography; Lymphangiomatosis; Neoplasms

MeSH Terms

Adult
Colon/ultrasonography
Colonic Neoplasms/*diagnosis/pathology/ultrasonography
Colonoscopy
Endosonography
Female
Humans
Lymphangioleiomyomatosis/*diagnosis/pathology/ultrasonography

Figure

• 

  Fig. 1 Air contrast barium enema showed multiple thumbprint-like lesions (arrows), ranging from 7 to 20 mm in diameter, mainly in the ascending colon.

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  Fig. 2 Endoscopic views of a cluster of elevated lesions, with a smooth surface and gentle slope, in the ascending colon. (A, B) The overlying mucosa was intact and appeared thin, and the lesion was soft and compressible.

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  Fig. 3 EUS images of the colon, obtained with a catheter EUS probe (frequency 12 MHz). (A) The EUS image depicting elevated lesions as echo-free cysts (arrowheads) in the submucosal layer. (B) Some submucosal cysts had septal walls (arrows).

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  Fig. 4 Microscopic findings. (A) Endoscopic biopsy revealed submucosal cyst with occasional multinucleated cells (inset), however, there were no fat or blood cell components (H&E, ×20; inset: H&E, ×400). (B) D2-40 immunostaining showed positive reactivity (arrows) for lining endothelial cells of lymphatic spaces (Polymer method, ×200).

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