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Radiology
Symptomatic presentation and imaging features of a chylous cystic lymphangioma
  1. Lily Kwak1,
  2. Matteen Hakim2,
  3. Gabriel Ivey3 and
  4. Claire Brookmeyer2
  1. 1The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  3. 3Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Claire Brookmeyer; cbrookm2{at}jhmi.edu

Abstract

A woman in her 60s presenting with 5 days of diffuse abdominal pain was diagnosed preoperatively with a chylolymphatic mesenteric cyst. MRI and CT imaging demonstrated a 5.8 cm unilocular cyst containing a fluid-fluid level within the mesentery. Following an uncomplicated open excision, the lesion was characterised by pathology as a cystic lymphangioma due to the presence of focal smooth muscle and lymphoid tissue in the wall. This case report discusses the radiologic features of rare lymphatic mesenteric cysts that can help guide preoperative diagnosis and highlights that postoperative diagnosis remains definitive. This case also underscores the importance of considering mesenteric cysts as a rare cause of abdominal pain in patients who have non-specific abdominal symptoms and a mass on imaging not associated with any single organ.

  • Radiology
  • Surgery

https://doi.org/10.1136/bcr-2024-261472

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    Footnotes

    • X @GDIveyMD

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: LK and CB. The following authors gave final approval of the manuscript: LK, MH, GI and CB. CB acted as guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.