Nagata Hiroshi, Yonemura Yutaka, Canbay Emel, Ishibashi Haruaki, Narita Makoto, Mike Makio, Kano Nobuyasu
Department of Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, 296-8602, Japan,
Surg Today. 2014 Jul;44(7):1367-70. doi: 10.1007/s00595-013-0654-x. Epub 2013 Jun 27.
We report a case of retroperitoneal cystic lymphangioma in a 30-year-old woman who presented with abdominal distention and pain. Imaging studies revealed a large, thin-walled multicystic mass occupying the whole abdomen. Based on a preoperative diagnosis of multicystic mesothelioma, we performed laparotomy, which revealed a tumor arising from the gastropancreatic ligament in the posterior wall of the omental bursa. We resected the tumor completely, without the adjacent viscera. The final pathological diagnosis was cystic lymphangioma, based on the immunohistochemical findings of positive CD31 and CD34 expression, the presence of smooth muscle confirmed by smooth muscle antigen and desmin, and negative calretinin, WT-1 and cytokeratins 5/6 expression. Multicystic mesotheliomas and cystic lymphangiomas are so similar in morphology that immunohistochemical staining should be fully utilized to differentiate them.
我们报告一例30岁女性的腹膜后囊性淋巴管瘤，该患者表现为腹胀和腹痛。影像学检查显示一个巨大的、薄壁的多囊性肿块占据整个腹部。基于术前多囊性间皮瘤的诊断，我们进行了剖腹手术，结果发现肿瘤起源于网膜囊后壁的胃胰韧带。我们完整切除了肿瘤，未累及相邻脏器。根据免疫组化结果，CD31和CD34表达阳性、平滑肌抗原和平滑肌肌动蛋白证实有平滑肌存在、钙视网膜蛋白、WT-1和细胞角蛋白5/6表达阴性，最终病理诊断为囊性淋巴管瘤。多囊性间皮瘤和囊性淋巴管瘤在形态上非常相似，因此应充分利用免疫组化染色来鉴别它们。
