Rare case of a solitary huge hepatic cystic lymphangioma

Abstract

A hepatic lymphangioma is a rare benign neoplasm and is usually associated with lymphangiomas of other viscera. A hepatic lymphangioma can be solitary, cystic or associated with multiple liver lesions and is characterized by cystic dilatation of lymphatic vessels in the hepatic parenchyma. A solitary lymphangioma is unusual. Here we report a rare case of a solitary huge primary hepatic cystic lymphangioma in a 42-year-old woman. It was discovered on routine physical examination and the patient had no obvious symptoms. Ultrasonography and computed tomography (CT) showed a giant "hepatic neoplasm" that occupied the right liver lobe. The lesion was approximately 20.0 cm × 15.0 cm × 10.0 cm in size and contained cystic and solid components. There were multiple septa inside the tumor, with some calcifications in the septa. Surgical resection was performed. Histological examination revealed multiple cystic structures lined with epithelial cells on the inner walls, accompanied by interstitial swelling and necrosis. The patient has now been followed up for nearly two years after surgery, with no recurrence to date.

Keywords: Cyst; Liver; Lymphangioma.

Figure 1

Computed tomography scan: A huge cystic mass with multiple septations is seen in the right lobe of the liver. There was no enhancement in the cystic regions but the septa were enhanced and seemingly had calcification.

Figure 2

Gross sample: cystic mass in the right liver lobe, measuring 23 cm × 15 cm × 7 cm.

Figure 3

Histopathological findings. A: Dilated lymphatic cavities accompanied with partial infarction. Lymph cells were seen lining the wall of the cyst, hematoxylin and eosin (HE), × 100; B: Simple squamous epithelia and eosinophilic hepatic cells (HE, × 200).