Mesenteric cysts and intra-abdominal cystic lymphangiomas
H. Takiff, R. Calabria, L. Yin and B. E. Stabile
Although mesenteric cysts and intra-abdominal cystic lymphangiomas are
uncommon and clinically confusing lesions, histologic and ultrastructural
evidence suggests that they are pathologically distinct. Differentiation of
these lesions is important since lymphangiomas may follow a proliferative
and invasive course. Of 28 cases documented at laparotomy, histologically
eight patients (29%) had cystic lymphangiomas and 20 patients (71%) had
mesenteric cysts. Lymphangioma was found to be exclusively a disease of
childhood and young adulthood (mean age, 10 years); mesenteric cyst was
found in all age groups (mean age, 44 years), and two thirds of these
patients were over 40 years old. Patients with lymphangiomas more
frequently were male (75% vs 30%), symptomatic (88% vs 35%), and had
ascites (50% vs 0%) and larger lesions (mean, 8.8 vs 4.7 cm) when compared
with patients with mesenteric cysts. Complete excision was possible in all
but four patients, with no operative deaths and a postoperative
complication rate of 7%. After a mean follow-up period of four years, there
were no recurrences among 16 patients who had undergone complete excision.
