Jha Tanvi, Sharma Monika, Ahuja Arvind
Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Department of Pathology, New Dehli, India.
Autops Case Rep. 2024 Feb 8;14:e2024470. doi: 10.4322/acr.2024.470. eCollection 2024.
Lymphangiomas are rare benign tumors that mainly involve the head and neck region in pediatric patients. Lymphangiomas of the small bowel mesentery in adults are rarer. We present two cases of mesenteric lymphangioma with acute abdominal pain on presentation. Case 1: A 38-year-old female presented with abdominal pain, vomiting, fever, and difficult evacuation. On abdominal examination, she had an ill-defined, tender lump, and radiological findings raised a possibility of perforation peritonitis. Thus, exploratory laparotomy was planned. Per-operatively, a mesenteric mass was found, which, on histopathological evaluation, was found to be a mesenteric lymphangioma involving the bowel. Case 2: A 27-year-old male presented with abdominal pain and difficult evacuation. Radiological evaluation revealed a multilobulated lesion involving the mesentery and with differential diagnoses of mesenteric fibromatoses and inflammatory pseudotumor. Histopathological assessment of the resected mass revealed a lymphangioma that was limited to the mesentery. Owing to their rarity and non-specific presentation, mesenteric lymphangiomas are often misdiagnosed on clinical examination and imaging. Thus, histopathological examination is the gold standard to reach a definitive diagnosis.
淋巴管瘤是一种罕见的良性肿瘤，主要累及小儿患者的头颈部区域。成人小肠系膜淋巴管瘤更为罕见。我们报告两例表现为急性腹痛的肠系膜淋巴管瘤病例。病例1：一名38岁女性，出现腹痛、呕吐、发热及排便困难。腹部检查时，发现一个边界不清、有压痛的肿块，影像学检查结果提示有穿孔性腹膜炎的可能。因此，计划进行剖腹探查术。术中发现一个肠系膜肿物，经组织病理学评估，发现是一个累及肠管的肠系膜淋巴管瘤。病例2：一名27岁男性，出现腹痛及排便困难。影像学评估显示一个多叶状病变累及肠系膜，鉴别诊断考虑肠系膜纤维瘤病和炎性假瘤。对切除肿物的组织病理学评估显示为一个局限于肠系膜的淋巴管瘤。由于肠系膜淋巴管瘤罕见且表现不具特异性，临床检查和影像学检查常出现误诊。因此，组织病理学检查是确诊的金标准。
