A case of mediastinal cystic lymphangioma surrounding the pericardium

Abstract

A 62-year-old man was admitted to our hospital with an abnormal shadow observed on a chest radiograph. CT revealed lesions that had spread extensively in the anterior mediastinum and were located near both hila, surrounding the pericardium. At 15 months after his first visit, chest pain had appeared and the lesions had enlarged; hence, we performed surgery through a median sternotomy approach. There were numerous, multilocular, cystic lesions in the thymus and circumferential adipose tissues; these cysts were filled with a light yellow, serous liquid. We performed complete resection using a thoracoscope. Immunohistochemically, the cells lining the cyst were positive for D2-40, which reacts with the lymphatic endothelium. These results combined with the macroscopic findings helped us diagnose him with cystic lymphangioma. This cystic lymphangioma, localized extensively in the thymus and circumferential adipose tissue, was considered an extremely rare case with a continually expanding tumor.