Abstract:
Lymphangiomas are cystic lesions that arise due to malformations
(congenital or acquired) in the lymphatic system and are composed of
thin-walled septa lined by endothelial cells that enclose blocked lymph
fluid. Lymphangiomas can occur in any part of the body, and at any age
but generally, 90% occur in children < 2 years of age and
90% times in the upper part of the body like head, neck, and axillae.
Abdominal lymphangiomas are rare (only 1% of all lymphangiomas) and
pancreatic are even rarer. When occurring in the pancreas, they mostly
present at later ages with recurrent abdominal pain +/- palpable
abdominal mass and mostly in ‘women’, although most commonly they are an
incidental finding. Here we present a case of a young ‘male’ with the
complaint of epigastric pain that responded to acetaminophen, USG and CT
raised the suspicion of cystic lymphangioma and EUS FNA showing
pathognomic lab findings in the aspirated fluid. A definitive diagnosis
can be made on histology. In asymptomatic patients, conservative
treatment is preferred while in patients with symptoms and compression
of adjoining structures due to size, En-bloc resection is curative with
an excellent prognosis.