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Case Reports
. 2018 Oct;97(41):e12599.
doi: 10.1097/MD.0000000000012599.

A giant hemolymphangioma of the pancreas: A case report and literature review

Qingyu Chen  1 , Jianguo Xia
Affiliations
Case Reports

A giant hemolymphangioma of the pancreas: A case report and literature review

Qingyu Chen et al. Medicine (Baltimore). 2018 Oct.

Abstract

Rationale: Hemolymphangioma of the pancreas is an extremely rare benign tumor; only 10 patients with this disease have been reported to date, the majority of whom were women.

Patient concerns: We describe a 28-year-old man who presented with abdominal pain and discomfort. Computed tomography and magnetic resonance imaging data showed a huge heterogeneous solid cystic mass at the retroperitoneal pancreatic head. The maximum cross-sectional lengths of the pancreatic lesion were approximately 12 × 8.5 × 12 cm.

Diagnosis: Hemolymphangioma of the pancreas.

Interventions: The patient underwent a pylorus-preserving pancreatoduodenectomy; surgical excision is the main treatment for this type of tumor.

Outcomes: The patient followed up regularly in the outpatient department for 6 months after surgery, and no sign of recurrence was found.

Lessons: Although it is uncommon, clinicians ought to consider the diagnosis of hemolymphangioma of the pancreas upon detection of a pancreatic cystic lesion exhibiting fat or calcification.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Computed tomography revealed a cystic-solid mass at the pancreatic head, with scattered spot-like calcification evident (arrows) and a small amount of adipose tissue (arrows) (A, B). The pancreatic head was pushed forward under pressure. The solid component was better visualized with mild enhancement (arrows) (C).
Figure 2
Figure 2
Magnetic resonance imaging (MRI) revealed an oval-shaped tumor of mixed signal intensity behind the pancreatic head on both T1-weighted imaging (WI) and T2WI with visible mild dynamic enhancement with a delay to strengthen the signal. T2WI with fat suppression showed small areas of low signal. (A) Plain MRI; (B) arterial phase MRI; (C) venous phase MRI; (D) T2WI. Arrows indicate pancreatic cystic lesion.
Figure 3
Figure 3
Hematoxylin–eosin staining showed some dysplastic lymphatic vessels and blood vessels infiltrated by amorphous necrotic material. Multinucleated giant cell hyperplasia could also be observed in the tumor (×100).
Figure 4
Figure 4
Immunohistochemical staining positive D2-40 staining in vascular endothelial cells (×100).
See this image and copyright information in PMC

References

    1. Figueroa RM, Lopez GJ, Servin TE, et al. Pancreatic hemolymphangioma. JOP 2014;15:399–402. - PubMed
    1. Fang YF, Qiu LF, Du Y, et al. Small intestinal hemolymphangioma with bleeding: a case report. World J Gastroenterol 2012;18:2145–6. - PMC - PubMed
    1. Dong F, Zheng Y, Wu JJ, et al. Hemolymphangioma: a rare differential diagnosis of cystic-solid or cystic tumors of the pancreas. World J Gastroenterol 2013;19:3520–3. - PMC - PubMed
    1. Montete P, Marmuse JP, Claude R, et al. Hemolymphangioma of the pancreas. J Chir (Paris) 1985;122:659–63. - PubMed
    1. Banchini E, Bonati L, Villani LG. A case of hemolymphangioma of the pancreas. Minerva Chir 1987;42:807–13. - PubMed

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