Colonic Lymphangiomatosis

Abstract

Lymphangiomas are benign malformations of the lymphatic vessels which can be primary or secondary in etiology. Colonic involvement is rare, and the diagnosis is mostly incidental. Sometimes, the initial endoscopic appearance can be misleading. We present a case of colonic lymphangiomatosis presenting with free air under the diaphragm requiring surgical removal of the involved portion of the colon. The diagnosis was confirmed by the pathology of the resected specimen and its correlation with prior clinical information. The patient recovered well with an uneventful postoperative course and follow-up. This case demonstrates a rare complication of colonic lymphangiomatosis prompting definitive treatment by surgical resection.

Keywords: colonic mass; intestinal perforation; lymph; lymphangiectasia; micro-perforation; non-cancer; primary intestinal lymphangiectasia; sigmoid; sigmoid colon; sigmoid perforation.

Figure 1. Colonic Lymphangiomatosis

(1a) Gross image of the sigmoid colon, bottom aspect showing partial deroofing of the mucosa of a simple cystic cavity (black arrow). (1b) Hematoxylin and eosin (H&E) stain 40X, and (1c) D2-40 positivity (brown membranous and cytoplasmic staining) 100X.