Figure 1
Mesenteric lymphangioma
US of upper left abdomen shows a thin-walled mass with a fluid-fluid level.
Clinical History
The patient presented with upper left abdominal pain of several days' duration.
Imaging Findings
The patient presented with upper left abdominal pain of several days' duration. On physical examination a painful upper left abdominal mass was palpable. Laboratory studies were normal. Radiological evaluation included US and CT scans.
Discussion
Lymphangioma is a congenital malformation of lymphatic vessels that produces a cystic mass. Lymphangioma usually appears in newborns and young children. The most common location for these benign tumours is the neck. Not unfrequently, lympangiomas arise from the mediastinum.
Although mesenteric lymphangioma is an unusual lesion, it is the most common type of mesenteric or omental cyst. Mesenteric lymphangioma can be fixed to the bowel wall and can produce partial obstruction with proximal dilatation. Other complications of lymphangiomas are infection and haemorrage.
Treatement is surgical removal and, on occasions, can require bowel resection.
Diagnosis can be made on radiological investigation. On US, lymphangioma is a septated, cystic mass, that can contain internal echoes or show fluid-fluid levels. On CT, lymphangiomas can show attenuation values in the range of water (if the contents are serous), of fat (if the contents are chylous), or in the range of blood (if the contents are haemorrhagic). MRI can also detect amounts of fatty tissue, and help with accurate diagnosis.
Treatement is surgical removal and, on occasions, can require bowel resection.
Differential Diagnosis List
Mesenteric cystic lymphangioma
Final Diagnosis
Mesenteric cystic lymphangioma
References
[1]
Stoupis C, Ros PR, Abbitt PL, Burton SS, Gauger J.
Bubbles in the belly: imaging of cystic mesenteric or omental masses.
Radiographics. 1994 Jul;14(4):729-37. (PMID: 7938764)
[2]
Friedman AC, Hartman DS, Sherman J, Lautin EM, Goldman M.
Computed tomography of abdominal fatty masses.
Radiology. 1981 May;139(2):415-29. (PMID: 7220888)
[3]
Waligore MP, Stephens DH, Soule EH, McLeod RA.
Lipomatous tumors of the abdominal cavity: CT appearance and pathologic correlation.
AJR Am J Roentgenol. 1981 Sep;137(3):539-45. (PMID: 6974467)
Case information
| URL: | https://www.eurorad.org/case/1901 |
| DOI: | 10.1594/EURORAD/CASE.1901 |
| ISSN: | 1563-4086 |
Mesenteric lymphangioma
US of upper left abdomen shows a thin-walled mass with a fluid-fluid level.
