A Right Mesocolic Lymphangioma in a 20-year-old Woman—A Case Report—

Abstract

Lymphangioma commonly occurs in children in the head and neck region, and it is rarely seen in adults or in the mesentery. A 20-year-old woman presented to the emergency department complaining of right lower abdominal pain. On investigation, WBC was 11,700/μL, CRP was 6.56 mg/dL, and computed tomography showed a 100-mm, multilocular cystic mass in the right abdomen. On imaging, the mass was starting to enclose the ileocolic artery and vein, but it did not pass the right margin of the superior mesenteric vein, maintained clear margins with adjacent organs, and had no evident solid component. The differential diagnosis included lymphangioma, mucinous cystic adenoma, and cystic mesothelioma, and it was decided to resect the mass for both therapeutic and diagnostic purposes. When the abdomen was opened, the lesion was seen within the right mesocolon, and en bloc right hemicolectomy was conducted. Histologically, the cyst consisted of an irregularly dilated large vessel lined by simple epithelium that was positive for CD31 and D2-40, but negative for CD34, resulting in a diagnosis of lymphangioma. One year later, the patient remains recurrence-free. This case is reported along with an analysis and discussion of previous reports of adult mesocolic lymphangioma in Japan.