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.