History: 32 yo male with RLQ abdominal pain
Solution: Cystic Lymphangioma
A well circumscribed mass with fluid attenuation located in the mesentery is identified on this examination. The patient is young and based upon the history (RLQ pain), this is likely to represent an incidental finding. A lymphangioma is a congenital malformation of lymphatic vessels. It is usually identified as a thin-walled cystic mass and can contain chylous, serous, or hemorrhagic fluid. It is usually centered in the mesentery, but can affect bowel, resulting in obstruction. The differential would include an enteric duplication cyst/enteric cyst, cystic mesothelioma, cystic teratoma, or loculated ascites, and the diagnosis can only be confirmed with histology.
Although it is a benign process, it is often treated surgically due to the risk of complications such as obstruction, hemorrhage, rupture, infection, torsion, volvulus, and obstuction of the urinary or biliary tract. It has an excellent prognosis after enucleation and a low recurrence rate.
A well circumscribed mass with fluid attenuation located in the mesentery is identified on this examination. The patient is young and based upon the history (RLQ pain), this is likely to represent an incidental finding. A lymphangioma is a congenital malformation of lymphatic vessels. It is usually identified as a thin-walled cystic mass and can contain chylous, serous, or hemorrhagic fluid. It is usually centered in the mesentery, but can affect bowel, resulting in obstruction. The differential would include an enteric duplication cyst/enteric cyst, cystic mesothelioma, cystic teratoma, or loculated ascites, and the diagnosis can only be confirmed with histology.
Although it is a benign process, it is often treated surgically due to the risk of complications such as obstruction, hemorrhage, rupture, infection, torsion, volvulus, and obstuction of the urinary or biliary tract. It has an excellent prognosis after enucleation and a low recurrence rate.
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