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Arch Surg. 2005;140:412.

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Answer: Giant Multicystic Lymphangioma

Frozen section analysis of biopsy material could not clearly distinguish between lymphangioma, lymphangiosarcoma, teratoma, or the possibility of an inflammatory pseudotumor; a small blue-cell tumor, however, was excluded. Contents of the cysts appeared chylous. The final pathology analysis was consistent with a benign giant multicystic lymphangioma (or cystic hygroma). Mucin stains were negative; trichrome staining confirmed the presence of smooth muscle strands within the cyst walls.

Giant multicystic lymphangiomas are rare congenital malformations of the lymphatic system. These lesions result from a proliferation of dilated lymphatic spaces lined by thin endothelial layers.¹ They are thought to develop when primary lymphatic sacs fail to join the lymphatic system during embryologic development.^2-3 Lymphangiomas rarely present as intra-abdominal tumors; the majority of those that do are found in younger children. Lymphangiomas most commonly occur within the soft tissues of the head and neck, and they are also called cystic hygromas.⁴ Within the abdomen, . . . [Full Text of this Article]

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Arch Surg. 2005;140(4):411.
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