A case of a huge multilobular cystic lymphangioma of the stomach

Abstract

A 54-year-old man was seen at the hospital because of abdominal discomfort and upper abdominal pain. On abdominal physical examination, there were distention and mild degree of tenderness in the upper middle portion of abdomen. An abdominal CT scan revealed a 19×14×8cm multilobular cyst compressing the left lobe of liver and the stomach. Abdominal MRI showed a cystic lesion with septum in its center which was visualized as low signal intensity on T1-weighted images and as high signal intensity on T2-weighted images. Laparotomy was thus performed with a suspected diagnosis of an outgrowing type multiple liver cyst. As a result, we identified a huge multilobular cyst with a thin capsule arisen from the lesser curvature of the upper body of the stomach. Since its adhesions with the surrounding tissues were negligible, the cyst was removed with a part of the gastric wall. The cystic fluid was faintly yellowish and slightly clouded lymph which amounted to about 1200ml. The pathohistological diagnosis was lymphangioma composed of dilated lumen showing a lymphatic vessel like structure. Huge multilobular cystic lymphangioma of the stomach is a rare entity, and hence its clinical characteristics together with our case are reported here.