One child was hospitalized because of repeated cough and sputum. The biopsy diagnosis in local hospital was cystic lymphangioma in retropharyngeal space. We carried out transoral incision and drainage by catheter under general anesthesia. Put into the surgical cavity a suction drainage tube, and injected 5 mg dexamethasone and 8mg Bleomycin. He had nasogastric liquid diet after operation. We removed the suction drainage tube two weeks later. No recurrence was found following up over two years.
Child ; Humans ; Lymphangioma, Cystic ; diagnosis ; surgery ; Pharynx ; pathology ; surgery

OBJECTIVETo study the pathogenesis, pathologic features and prognosis of fetal nuchal cystic hygroma.

METHODSForty autopsied cases of fetal nuchal cystic hygroma were collected during January 2003 to December 2012. The clinical history, pathologic changes and immunohistochemical (EnVision method) findings were reviewed, and the pathogenesis and pathologic characteristics were analyzed.

RESULTSOf the 40 cases, 16 (40.0%) showed single malformation and 24 (60.0%) were associated with multiple malformations in other organs and/or systems.Nineteen cases were septated and 21 were not. The associated malformations occurred in the respiratory system, skeletal system and urinary system.In the cases of combined malformations of umbilical cord, 3 were single umbilical artery malformations and 1 was torsion and stricture of umbilical cord.Four cases had chromosomal analysis, and all were trisomy-21.

CONCLUSIONSFetal nuchal cystic hygroma is a rare disease. The etiology is unknown, but it is not neoplastic.Lymphangioma is divided into 3 types:capillary lymphangioma, cavernous lymphangioma and cystic hygroma according to their expansile growth pattern. The overall prognosis is determined by any co-existing chromosomal anomalies, associated malformations and the time of diagnosis of the cystic hygroma.

Antibodies, Monoclonal, Murine-Derived ; metabolism ; Autopsy ; Calbindin 2 ; metabolism ; Female ; Fetus ; pathology ; Humans ; Hydrops Fetalis ; metabolism ; pathology ; Lymphangioma, Cystic ; metabolism ; pathology ; Male ; Pregnancy ; Pregnancy Outcome

Capsule Endoscopy ; Child, Preschool ; Female ; Gastrointestinal Neoplasms ; etiology ; pathology ; Humans ; Lymphangioma, Cystic ; etiology ; pathology ; Nevus, Blue ; etiology ; pathology ; Skin Neoplasms ; etiology ; pathology

BACKGROUND/AIMS: Cystic lymphangioma is an uncommon disease, and rarely develops in the intraabdomen. The aim of this article was to discuss about clinical characteristics of intraabdominal cystic lymphangioma developed in Korea. METHODS: Age, sex, symptoms, locations and size of the lesions, diagnostic methods, treatments, complications and recurrence were analyzed in 13 pathologically confirmed cases of intraabdominal cystic lymphangioma and 18 cases of literature consideration reported in Korea. RESULTS: Intraabdominal cystic lymphangioma commonly developed in adults compared to the other lymphangioma, and frequently located in the mesentery. Abdominal pain was the most common symptom, but it was a non-specific finding. Tenderness and abdominal mass were not significantly associated. The size of mass was diverse. Abdominal ultrasonography and abdominal CT were diagnostic tools most commonly used, but preoperative diagnosis was possible only in 22.6%. All patients were discharged without any complications, and no recurrence was reported. CONCLUSIONS: Preoperative diagnosis of intraabdominal cystic lymphangioma is difficult and symptoms and signs are not specific. Intra-abdominal cystic lymphangioma should be suspected in patients with non specific abdominal pain and intraabdominal mass and active diagnostic evaluation is mandatory.
Abdominal Pain/etiology ; Adult ; Aged ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Lymphangioma, Cystic/*diagnosis/pathology/ultrasonography ; Male ; Mesentery/pathology ; Middle Aged ; Omentum/pathology ; Peritoneal Neoplasms/*diagnosis/pathology/ultrasonography ; Prognosis ; Republic of Korea ; Tomography, X-Ray Computed

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

OBJECTIVETo investigate the clinical and pathological features, diagnosis and treatment of cystic lymphangioma of the spermatic cord.

METHODSOne case of cystic lymphangioma of the spermatic cord in a 71-year-old patient was retrospectively analyzed and the relevant literature was reviewed.

RESULTSThe patient, presented with spermatic cord hydrocele, was treated by local excision of the tumor, which was pathologically diagnosed as cystic lymphangioma. No relapse was found during a 3-month follow-up after the operation.

CONCLUSIONLymphangioma of the spermatic cord is a benign tumor. Preoperation ultrasonography and CT are important for determining the location and nature of lymphangioma. Surgical excision is an effective option for the treatment of cystic lymphangioma of the spermatic cord.

Aged ; Genital Neoplasms, Male ; diagnosis ; surgery ; Humans ; Lymphangioma, Cystic ; diagnosis ; surgery ; Male ; Retrospective Studies ; Spermatic Cord ; pathology ; Treatment Outcome

OBJECTIVETo study the clinicopathologic features and differential diagnosis of splenic lymphangioma.

METHODSEighteen cases of splenic lymphangioma were retrieved from the pathology archives during the period between January 1990 to December 2005. The clinicopathologic features were analyzed. Immunohistochemical study was performed on the paraffin sections of 16 cases.

RESULTSThe age of the patients ranged from 9 to 72 years (median = 40 years). Thirteen patients were males and 5 were females. Clinically, the tumor could be asymptomatic or present with abdominal symptoms and hypersplenism. Follow-up information was available in 13 patients (72.2%) and the duration varied from 5 months to 15 years. All 13 patients had an uneventful clinical course, with no evidence of residual disease, local recurrence or metastasis. Gross examination showed splenic enlargement. The tumor appeared as cystic (8/18), solid (5/18) or honeycomb mass (5/18), either solitary (5/18) or multifocal (13/18). Histologically, splenic lymphangioma could be subclassified as cavernous (9/18), cystic (5/18) or mixed (4/18). Immunohistochemical study showed that the positivity rates for CD9 and D2-40 were 100% and 43.8% respectively.

CONCLUSIONSSplenic lymphangioma is a rarely encountered entity that can be misdiagnosed as a splenic hemangioma. A definite diagnosis depends on pathologic examination.

Adult ; Aged ; Antibodies, Monoclonal ; metabolism ; Antibodies, Monoclonal, Murine-Derived ; Antigens, CD ; metabolism ; Biomarkers, Tumor ; metabolism ; Child ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioma ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Lymphangioma ; metabolism ; pathology ; surgery ; Lymphangioma, Cystic ; metabolism ; pathology ; surgery ; Male ; Membrane Glycoproteins ; metabolism ; Middle Aged ; Splenectomy ; Splenic Neoplasms ; metabolism ; pathology ; surgery ; Tetraspanin-29

Cystic lymphangioma of the gallbladder is quite a rare tumor with only a few cases having been reported in the literature. We describe here a rare case of cystic lymphangioma of the gallbladder, which was unusual in that the patient presented with biliary pain and an abnormal liver test. Ultrasonography and computed tomography of the abdomen showed a multi-septated cystic mass in the gallbladder fossa and an adjacent compressed gallbladder. Endoscopic retrograde cholangiography showed there was no communication between the bile tract and the lesion, and there were no other abnormal findings with the exception of a laterally compressed gallbladder. After performing endoscopic sphincterotomy, a small amount of sludge was released from the bile duct. The histological findings were consistent with a cystic lymphangioma originating from the subserosal layer of the gallbladder. This unusual clinical presentation of a gallbladder cystic lymphangioma was attributed to biliary sludge, and this was induced by gallbladder dysfunction that was possibly from compression of the gallbladder due to the mass.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Female ; Gallbladder Neoplasms/*diagnosis/pathology/surgery ; Humans ; Lymphangioma, Cystic/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; Ultrasonography

Chylopericardium is a rare clinical entity in which chylous fluid accumulates in the pericardial cavity. We report a case of primary idiopathic chylopericardium associated with multiple, small cervicomediastinal cystic hygromas occurring in an asymptomatic 43-year-old woman with no history of trauma, thoracic surgery, malignancy, infection or tuberculosis. Echocardiography showed a large amount of pericardial effusions and pericardial fluid analysis revealed inappropriately elevated triglyceride. We did not demonstrate communication between the thoracic duct and the pericardial sac by lymphangiography and chest computed tomography. She successfully responded to 30 days of continuous pericardial drainage and 15 days of a medium-chain triglyceride diet after 30 days of total parenteral nutrition. Follow-up echocardiography 6 months after treatment commencement showed a minimal reaccumulation of pericardial fluid without symptom. We conclude that if a patient is asymptomatic and can well tolerate daily life, surgery including pericardiectomy or ligation of the thoracic duct is not necessarily required.
Adult ; Female ; Humans ; Lymphangioma, Cystic/*complications/pathology ; Mediastinal Cyst/*complications/pathology ; Neck/pathology ; Pericardial Effusion/*etiology/pathology/therapy

PURPOSE: Concerns about patients experiencing overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures, and the advanced understanding of splenic vascular anatomy has permitted splenic preserving operations and conservative medical management. These are now accepted alternative procedure when dealing with pathologically benign splenic conditions and traumatic splenic injuries. The aim of the present paper was to evaluate the effectiveness and safety to this new spleen conserving procedure compare to open splenectomy. METHODS: From December 1999 through April 2004, five patients with splenic cysts who were treated by splenectomy and laparoscopic function preserving surgery (LFPS) were enrolled in this study. We analyzed the operation time, the amount of blood loss, the time to restart a regular diet, the hospital stay and the postoperative CT to retrospectively confirm the results of the operations. RESULTS: In four cases, the pathologic findings were splenic pseudocysts, and the other case was a cystic lymphangioma. The operative times were 138 minutes (range: 120~156 minutes) for LFPS and 130 minutes (range: 100~170 minutes) for total splenectomy. The amounts of blood loss were 20~30 cc for LFPS, and 20~800 cc for open splenectomy. For LFPS, the patients started their diet at postoperative day 1st and they were discharged at 4th (range: 3~5) day without complication. But for total splenectomy, normal diet was started at the 3rd day (range: 2~4) and they were discharged at the 11th day (range: 3~22) and one patient had complications. For LFPS, on the CT that was done 3 month after operation, we confirmed the complete excision of cysts without any operation related complication, there was no evidence of recurrence and the splenic parenchyme was preserved in a normal fashion in all cases. CONCLUSION: The success and relative ease of performing this laparoscopic function preserving procedure will pave the way for its future use in other selective cases involving splenic pathology.
Diet ; Humans ; Length of Stay ; Lymphangioma, Cystic ; Operative Time ; Pathology ; Recurrence ; Retrospective Studies ; Sepsis ; Spleen ; Splenectomy