J Korean Med Sci.  2009 Dec;24(6):1212-1215. 10.3346/jkms.2009.24.6.1212.

Acquired Omental Cystic Lymphangioma after Subtotal Gastrectomy: A Case Report

• Kim JH
• Ryu WS
• Min BW
• Song TJ
• Son GS
• Kim SJ
• Kim YS
• Um JW

• KMID: 1783159
• DOI: http://doi.org/10.3346/jkms.2009.24.6.1212

Abstract

We herein describe a case of cystic lymphangioma in the greater omentum of the remnant stomach, which is thought it to be related with subtotal gastrectomy 10 yr ago for early gastric cancer. A 76-yr-old man was admitted to our department with postprandial abdominal discomfort and bowel habit change. Intraabdominal multilocular cystic mass was detected by ultrasonography and computed tomography. We performed a complete En-bloc tumor resection including spleen and distal pancreas, and histological examination confirmed cystic lymphangioma originated from the greater omentum of the remnant stomach. Although the etiology of omental lymphangioma remains largely unclear, these findings suggested strongly that obstruction of the lymphatic vessels after gastric resection for gastric carcinoma might be the most plausible cause. The surgical extirpation with resection of organs involved appears to be a treatment of choice for such unusual case.

Keyword

Abdominal Neoplasms; Surgery; Lymphangioma; Omentum; Gastrectomy; Adult

MeSH Terms

Aged
*Gastrectomy
Gastric Stump/*pathology
Humans
Lymphangioma, Cystic/*pathology
Male
Omentum/*pathology
Stomach Neoplasms/surgery

Figure

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  Fig. 1 An abdominal CT scan showed about 12.0×15.0 cm sized non-enhancing cystic mass in the left abdominal cavity. This mass was attached to pancreas body and tail superomedially, and displaced a remnant of stomach medially, spleen laterally, and adjacent bowel loops inferomedially. This cystic mass contained internal septum, like structure in the upper aspect of tumor.

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  Fig. 2 Gross specimen showed an encapsulated cystic tumor combined with distal pancreas and spleen (A, Anterior view; B, Posterior view).

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  Fig. 3 Histology of lymphangioma. (A, B) Cystic wall was consisted of fibroconnective tissue accompanied by dilated lymphatic spaces and lymphoid cell aggregations in the endothelial lining of lymphatic vessels (H&E ×100, ×400). Immunohistochemical staining. (C) Positive for CD31 in the lining cells of dilated lymphatic vessels (×400). (D) Positive for SMA in the cystic wall, and they were smooth muscle bundles surrounding lymphatic vascular endothelium (×400).

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