Clin Endosc.  2013 Sep;46(5):595-597.

Retroperitoneal Cystic Lymphangioma Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration

• Black T
• Guy CD
• Burbridge

Abstract

Retroperitoneal cystic lymphangiomas are rare tumors of the lymphatic system. These tumors usually present in childhood and are often diagnosed incidentally with imaging procedures. Although benign, they can grow to large sizes and become symptomatic due to their compressive effects. They can cause diagnostic dilemmas with other retroperitoneal cystic tumors including those arising from the liver, kidney, and pancreas. Endoscopic ultrasound (EUS) has become an invaluable tool in the assessment of cystic lesions in the region of the pancreas. This case describes a 66-year-old female who presented with 3 months of abdominal pain. Radiographic imaging was suggestive of a cystic lesion in the region of the pancreas. EUS was performed confirming a cystic lesion adjacent to the tail of the pancreas with subsequent fine needle aspiration fluid analysis consistent with a cystic lymphangioma.

Keyword

Endosonography; Biopsy, fine-needle; Lymphangioma

MeSH Terms

Abdominal Pain
Aged
Biopsy, Fine-Needle
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Female
Humans
Kidney
Liver
Lymphangioma
Lymphangioma, Cystic
Lymphatic System
Pancreas
Retroperitoneal Neoplasms

Figure

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  Fig. 1 Magnetic resonance imaging abdomen showing cystic lesion in region of pancreas.

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  Fig. 2 Endoscopic ultrasound showing cystic lesion adjacent to pancreas.

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  Fig. 3 H&E stain at ×100 magnification shows variably sized, dilated endothelial-lined spaces with a hypocellular, fibrovascular connective tissue stroma, and collections of lymphocytes.

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  Fig. 4 Immunohistochemistry for D240, a marker for lymphatic endothelium (×100).

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