Adrenal lymphangioma masquerading as a pancreatic tail cyst

Figure 1 Abdominal ultrasonography shows a cystic mass with luminal calcification (white arrow) that measures 14 cm in diameter in the left retroperitoneum.

Figure 2 Computed tomography scans show a large low-attenuation lesion measuring 16 cm in the pancreatic tail with luminal calcification (white arrow) (A), the cyst abutting the pancreas (B), a large cystic mass in the retroperitoneum (C); the cystic mass below the pancreas (D).

Figure 3 Magnetic resonance imaging images reveal a large cystic lesion on T2-weighted images (A), and the cyst could be observed abutting the pancreas (B).

Figure 4 Pathologic pictures. A: The gross size of the cyst was 13.0 cm × 8.0 cm, and the adrenal gland contained smaller cysts with a thin membranous appearance; B: Multiple thin-walled cysts of variable size, with remaining adrenal tissue in the intervening septae of the cysts (hematoxylin-eosin staining, × 100); C: Immunostaining with the D2-40 antibody is positive along the lining of the cysts, thus revealing lymphatic vessels.