- Neoplasms, hamartomas, or lymphangiectasias ?
- Malformations arising from sequestered lymphatic channels
- Acquired lesions due to obstruction caused by fibrosis of lymph channels.
- Developmental anomaly, distension of sequestered lymphatic channels within primitive mesenchyme rather than a true neoplasm.
- Most common sites: head, neck, and axilla.
- Only 5 % at mesentery, omentum, mesocolon, and retroperitoneum.
- Pancreatic lymphangiomas (1%) occur predominantly in women (F/M: 2:1). Average age : 25.6 years.
- Cystic, capillary, and cavernous.
- Only cystic and cavernous types have been reported in the pancreas
- Considered to be of pancreatic origin :
- in the pancreatic parenchyma,
- adjacent to the pancreas,
- connected to the organ by a pedicle
- Abdominal pain
- Palpable mass
- Silent, incidental finding.
- No risk of malignant transformation.
- May local invasion.
- Strong tendency for local recurrence unless they are completely excised.
- Soft, multiloculated cystic masses.
- Content: serous, serosanguinous, or lymphatic fluid.
- Dilated lymphatic channels, separated by thin septa.
- Cystic spaces lining: flattened or cuboidal endothelial cells.
- Aggregates of lymphocytes.
- The septa and walls: smooth muscle fascicles and collagenous connective
Image -- Sonography character
- Anechoic or hypoechoic
- Multiseptated mass in the pancreatic region.
Image -- CT character
- Homogeneous cystic masses in or adjacent to the pancreas.
- Septums and thin walls may enhance after IV contrast injection.
Image -- MRI character
- Hypointense on T1-weighted image
- Hyperintense on T2-weighted image.
- Not provide new information.
- Imaging: sono, CT, MRI
- Fine-needle aspiration cytology.
- Definite diagnosis: pathology report.
- No proven medical care for lymphangiomas exists.
- Treatment of choice: complete surgical excision.
- Lymphangiomas are benign hamartomatous malformations instead of true neoplasms.
- Locally invasion may occur.
- The prognosis is excellent.