Extrinsic Indentation at Gastric Fundus by Splenic Lymphangioma

위저부의 외부압박 소견으로 진단된 비장의 림프관종 1예

  • Dong, Shi-Heon (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Kim, Hee-Man (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Cho, Jae-Hee (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Lee, Hee-Woo (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Lee, Seung-Won (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Kang, Beo-Deul (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Song, Sun-Ok (Department of Internal Medicine, College of Medicine, Kwandong University) ;
  • Yi, Sang-Yeop (Department of Internal Medicine, College of Medicine, Kwandong University)
  • 동시헌 (관동대학교 의과대학 내과학교실) ;
  • 김희만 (관동대학교 의과대학 내과학교실) ;
  • 조재희 (관동대학교 의과대학 내과학교실) ;
  • 이희우 (관동대학교 의과대학 내과학교실) ;
  • 이승원 (관동대학교 의과대학 내과학교실) ;
  • 강버들 (관동대학교 의과대학 내과학교실) ;
  • 송선옥 (관동대학교 의과대학 내과학교실) ;
  • 이상엽 (관동대학교 의과대학 내과학교실)
  • Published : 2011.01.30

Abstract

Splenic lymphangioma is a very rare benign condition, and it is classified as one of the cystic proliferations of the spleen. This is considered to result from developmental malformation of the lymphatic system. Splenic lymphangioma is usually seen in children and it is often found incidentally. Herein, we report on an unusual case of splenic lymphangioma in an adult. A 66-year-old woman presented with abdominal pain. On esophagogastroduodenoscopy, the gastric fundus was externally compressed by an extrinsic mass. Computed tomography revealed multiple cystic masses in the spleen. Laparoscopic splenectomy was then performed. The histology revealed multiple splenic lymphangiomas. This case showed an unusual presentation of splenic lymphangioma as gastric extrinsic compression, and this should be examined by imaging studies.

림프관종은 양성 종양으로 주로 경부나 액와부에서 발견되며 종격동이나 후복강, 여러 내부 장기에서도 발견될 수 있는데 비장 림프관종은 매우 드물며 우연히 발견되는 경우가 많다. 본 증례는 복부 통증을 주소로 내원한 66세 여자 환자에게 시행한 상부 위장관내시경에서 위저부의 외부 압박으로 보이는 소견이 있었고 복부 전산화단층촬영에서 비장의 다발성 낭성종양으로 관찰되어 복강경 비장절제술을 시행 받고 비장 림프관종으로 진단된 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Goetsch E. Hygroma colli cysticum and hygroma axillare: pathologic and clinical study and report of 12 cases. Arch Surg 1938;36:394-479. https://doi.org/10.1001/archsurg.1938.01190210023005
  2. Wadsworth DT, Newman B, Abramson SJ, Carpenter BL, Lorenzo RL. Splenic lymphangiomatosis in children. Radiology 1997;202:173-176. https://doi.org/10.1148/radiology.202.1.8988208
  3. Patti R, Iannitto E, Di Vita G. Splenic lymphangiomatosis showing rapid growth during lactation: a case report. World J Gastroenterol 2010;16:1155-1157. https://doi.org/10.3748/wjg.v16.i9.1155
  4. Avigad S, Jaffe R, Frand M, Izhak Y, Rotem Y. Lymphangiomatosis with splenic involvement. JAMA 1976;236:2315-2317. https://doi.org/10.1001/jama.1976.03270210041022
  5. Ramani P, Shah A. Lymphangiomatosis. Histologic and immunohistochemical analysis of four cases. Am J Surg Pathol 1993;17:329-335. https://doi.org/10.1097/00000478-199304000-00002
  6. Schmid C, Beham A, Uranus S, et al. Non-systemic diffuse lymphangiomatosis of spleen and liver. Histopathology 1991;18:478-480. https://doi.org/10.1111/j.1365-2559.1991.tb00884.x
  7. Vezzoli M, Ottini E, Montagna M, et al. Lymphangioma of the spleen in an elderly patient. Haematological 2000;85:314-317.
  8. Arber DA, Strickler JG, Weiss LM. Splenic mesothelial cysts mimicking lymphangiomas. Am J Surg Pathol 1997;21:334-338. https://doi.org/10.1097/00000478-199703000-00010
  9. Abdel-Wahab M, Abou-Elenin A, Sultan A, EI-Ghawalpy N, Ezzat F. Lymphangiomatous cysts of the spleen. Report of 3 cases and review of the literature. Hepatogastroenterology 1998;45:2101-2104.
  10. Solomou EG, Patriarheas GV, Mpadra FA, Karamouzis MV, Dimopoulos I. Asymptomatic adult cystic lymphangioma of the spleen: case report and review of the literature. Magn Reson Imaging 2003;21:81-84. https://doi.org/10.1016/S0730-725X(02)00624-0