FIGURE 3: Axial Contrast enhanhed CT in venous phase showing mass
abutting the left adrenal gland.
Further evaluation by the ultrasound-guided aspiration to check for LDH
and Triglycerides level in the aspirated fluid was advised. Informed
consent was obtained. Sterile prep and drape were done. The patient was
placed in the supine position. Local anesthesia with 2% Xylocaine was
given. Under direct ultrasound guidance, an 18 G LP needle was inserted
into the lesion in the epigastrium. 30 cc of straw-colored fluid
aspirated. No complications were seen. This aspirated fluid was sent to
the pathology department for further workup. LDH levels and
Triglycerides levels were significantly raised in this body fluid and a
diagnosis of pancreatic lymphangioma was made.