Dukmak Osama N, Sarhan Fajr M A, Mohammad Saad Mufid Ali, Emar Mohammad, Al Zaro Rashad, Salhab Rafiq M A
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Int J Surg Case Rep. 2022 Sep;98:107540. doi: 10.1016/j.ijscr.2022.107540. Epub 2022 Aug 22.
Gallbladder lymphangiomas are very-rare, yet benign tumors that start developing in early life. Those tumors often go unnoticed until adulthood as they grow into a larger size or a complication happens. Despite its rarity, suspicion for the diagnosis should be maintained by the physicians.
A 14-year-old female patient presented to the hospital complaining of right upper quadrant abdominal pain of one month duration. Physical examination showed mild upper quadrant tenderness. Serology testing for the patient only showed eosinophilia. Computed tomography showed a large non-enhancing cystic lesion attached to the gallbladder. Presumptive diagnosis of hydatid cyst was made, and the patient was treated accordingly. Histological analysis of mass showed dilated lymphatic vessels, hence the shift in diagnosis towards a lymphangioma was made.
Gallbladder lymphangioma are usually asymptomatic, but they can present with pain, nausea and vomiting. Multiple complications had been reported including compression of the nearby structures, intra-abdominal infection, rupture, torsion or hemorrhagic transformation. Surgical removal of the mass is the treatment of choice.
Right upper quadrant pain can be the presenting symptom of liver pathology. Histological assessment is needed to confirm the diagnosis which will show dilated lymphatic vessels.
胆囊淋巴管瘤极为罕见，却是在生命早期开始发展的良性肿瘤。这些肿瘤在成年之前往往未被察觉，直到它们长得更大或出现并发症。尽管其罕见，但医生仍应保持对该诊断的怀疑。
一名14岁女性患者因持续一个月的右上腹疼痛前来医院就诊。体格检查显示上腹部轻度压痛。该患者的血清学检测仅显示嗜酸性粒细胞增多。计算机断层扫描显示胆囊附着有一个大的无强化囊性病变。初步诊断为包虫囊肿，并对患者进行了相应治疗。肿块的组织学分析显示淋巴管扩张，因此诊断转向淋巴管瘤。
胆囊淋巴管瘤通常无症状，但也可能表现为疼痛、恶心和呕吐。已报道了多种并发症，包括对附近结构的压迫、腹腔内感染、破裂、扭转或出血性转化。手术切除肿块是首选治疗方法。
右上腹疼痛可能是肝脏病变的表现症状。需要进行组织学评估以确诊，这将显示淋巴管扩张。
