A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst

Mesenteric cystic lymphangioma is a rare malformation of the lymphatic system. The incidence is very low (1 per 250,000). Although these entities usually follow a benign course, varying patterns of clinical presentations and overlapping features with chylolymphatic cysts, the histopathological diagn...

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Main Authors: Ketaki Makarand Deshpande, Vijayalaxmi M. Dhorigol, Vijay C Pujar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of the Scientific Society
Subjects:
Online Access:https://journals.lww.com/10.4103/jss.jss_359_24
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author Ketaki Makarand Deshpande
Vijayalaxmi M. Dhorigol
Vijay C Pujar
author_facet Ketaki Makarand Deshpande
Vijayalaxmi M. Dhorigol
Vijay C Pujar
author_sort Ketaki Makarand Deshpande
collection DOAJ
description Mesenteric cystic lymphangioma is a rare malformation of the lymphatic system. The incidence is very low (1 per 250,000). Although these entities usually follow a benign course, varying patterns of clinical presentations and overlapping features with chylolymphatic cysts, the histopathological diagnosis becomes tricky. Here, we report the case of intra-abdominal mesenteric cystic mass. A 10-year-old male patient presented with abdominal swelling and discomfort; provisional clinical diagnosis of chylolymphatic cyst was made; surgical excision of the cystic mass along with the bowel loop was done. Grossly, the cyst was congested externally with multiloculations inside and drained with whitish fluid. The multiple dilated lymphatic channels were surrounded by loose fibrocollagenous connective tissue on microscopic examination. It is important to differentiate mesenteric cystic lymphangioma from chylolymphatic cyst, since lymphangioma, although rare, can follow the invasive course. Histopathological examination is the gold standard for differentiating mesenteric cysts and diagnosing mesenteric cystic lymphangioma, and studying the literature was an out of common experience.
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spelling doaj-art-5666e99b451e40d2a1ec644b89fd131a2025-08-20T03:40:54ZengWolters Kluwer Medknow PublicationsJournal of the Scientific Society0974-50092278-71272025-04-0152216817010.4103/jss.jss_359_24A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric CystKetaki Makarand DeshpandeVijayalaxmi M. DhorigolVijay C PujarMesenteric cystic lymphangioma is a rare malformation of the lymphatic system. The incidence is very low (1 per 250,000). Although these entities usually follow a benign course, varying patterns of clinical presentations and overlapping features with chylolymphatic cysts, the histopathological diagnosis becomes tricky. Here, we report the case of intra-abdominal mesenteric cystic mass. A 10-year-old male patient presented with abdominal swelling and discomfort; provisional clinical diagnosis of chylolymphatic cyst was made; surgical excision of the cystic mass along with the bowel loop was done. Grossly, the cyst was congested externally with multiloculations inside and drained with whitish fluid. The multiple dilated lymphatic channels were surrounded by loose fibrocollagenous connective tissue on microscopic examination. It is important to differentiate mesenteric cystic lymphangioma from chylolymphatic cyst, since lymphangioma, although rare, can follow the invasive course. Histopathological examination is the gold standard for differentiating mesenteric cysts and diagnosing mesenteric cystic lymphangioma, and studying the literature was an out of common experience.https://journals.lww.com/10.4103/jss.jss_359_24cystic lymphangiomaintra-abdominal cystslymphaticsmesenteric cystpediatricsmall intestine
spellingShingle Ketaki Makarand Deshpande
Vijayalaxmi M. Dhorigol
Vijay C Pujar
A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst
Journal of the Scientific Society
cystic lymphangioma
intra-abdominal cysts
lymphatics
mesenteric cyst
pediatric
small intestine
title A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst
title_full A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst
title_fullStr A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst
title_full_unstemmed A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst
title_short A Pathologist’s Dilemma: Mesenteric Cystic Lymphangioma versus Mesenteric Cyst
title_sort pathologist s dilemma mesenteric cystic lymphangioma versus mesenteric cyst
topic cystic lymphangioma
intra-abdominal cysts
lymphatics
mesenteric cyst
pediatric
small intestine
url https://journals.lww.com/10.4103/jss.jss_359_24
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