Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 28, 2008; 14(44): 6873-6875
Published online Nov 28, 2008. doi: 10.3748/wjg.14.6873
Cystic lymphangioma of the pancreas
Radoje B Colovic, Nikica M Grubor, Marjan T Micev, Henry Dushan E Atkinson, Vitomir I Rankovic, Mihajlo M Jagodic
Radoje B Colovic, Nikica M Grubor, Marjan T Micev, Vitomir I Rankovic, Mihajlo M Jagodic, Institute for Digestive Diseases, Clinical Center of Serbia, First Surgical Clinic, Koste Todorovica 6, Belgrade11000, Serbia
Henry Dushan E Atkinson, Imperial College School of Medicine, St Mary’s Hospital, Praed Street, London W21NY, United Kingdom
Author contributions: The surgery and clinical care of the patient was undertaken by Colovic RB, Grubor NM, Jagodic MM; Micev MT did the histology and immunohistochemistry investigation; the paper was written by Colovic RB, Atkinson HDE and Grubor NM; Rankovic VI did the literature analysis; Grubor NM did all the corrections of the manuscript and the correspondence.
Correspondence to: Nikica M Grubor, MD, Assistant Professor of Surgery, First Surgical Clinic, Institute for Digestive Diseases, Clinical Center of Serbia, Koste Todorovica 6 Str, Belgrade 11000, Serbia. ngrubor@eunet.yu
Telephone: +381-11-3610715-133 Fax: +381-11-3618669
Received: June 2, 2008
Revised: September 13, 2008
Accepted: September 20, 2008
Published online: November 28, 2008
Abstract

Lymphangioma of the pancreas is an extremely rare benign tumour of lymphatic origin, with fewer than 60 published cases. Histologically, it is polycystic, with the cysts separated by thin septa and lined with endothelial cells. Though congenital, it can affect all age groups, and occurs more frequently in females. Patients usually present with epigastric pain and an associated palpable mass. Complete excision is curative, even though, depending on the tumour location, surgery may be simple or involve extensive pancreatic resection and anastomoses. The authors present a 49-year-old woman in whom a polycystic septated mass, 35 mm x 35 mm in size, was discovered by ultrasonography (US) in the body of the pancreas during investigations for epigastric pain and nausea. At surgery, a well circumscribed polycystic tumor was completely excised, with preservation of the pancreatic duct. The postoperative recovery was uneventful. Histology confirmed a microcystic lymphangioma of the pancreas. Immunohistochemistry showed cystic endothelial cells reactivity to factor VIII-RA (++), CD31 (+++) and CD34 (-). Postoperatively, abdominal pain disappeared and the patient remained symptomfree for 12 mo until now. Although extremely rare, lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of a pancreatic cystic lesion, especially in women.

Keywords: Pancreas; Cystic lymphangioma; Local surgical excision