Abstract
Lymphangioma can occur in every part of the body, but rarely found in the gastrointestinal organs, especially the large intestine. In this paper recent experience with lymphangioma of the descending colon is described with a review of 82 cases seen in the Japanese literature.
A 26-year-old man visited the hospital because of abdominal pain and melena. Barium enema study demonstrated an elevated lesion with smooth surface of the descending colon. Colonoscopy revealed a pale yellowish tumor with smooth surface in the descending colon, and the shape of the tumor was easily changed on compression. A diagnosis of submucosal tumor was made and the patient was operated on. The resected specimen revealed a 3.0×2.5 cm sized soft tumor with fluctation, the surface of which was covered with normal smooth mucosa. Microscopically, the tumor was diagnosed as cystic lymphanigoma.
In Japan, to our knowledge, 82 cases of lymphangioma of the colon and rectum have been reported since Yoshitoshi and collegues reported the first case. The mean age of the patients was 52.7 years, and the male to female ratio was 5:2. These tumors were found in whole regions of the large intestine, but about 72% of them were located through the cecum to transverse colon. The maximum diameters of the tumors ranged from 0.5-12 cm with an average of 3.1 cm. Twenty-seven cases had the diameter of less than 2 cm. In the treatment, endoscopic polypectomy was employed for the small lymphangiomas less than 2 cm in diameter, while surgical resection for the larger tumors. No malignant potential has been reported. It is important that we should take careful attitude to make the differential diagnosis and minimize surgical invasion.
