Pancreatic Cystic Lymphangioma

CASE REPORT Lymphangiomas are rare, benign, fluid-filled tumors that arise from an overgrowth or obstruction of the lymphatic system.1 Our patient was a 72-year-old woman with an incidentally found pancreatic lymphangioma. She had no history of diabetes mellitus, alcohol use, pancreatitis, or pancreatic cancer. The patient received computed tomography imaging for staging of urothelial cancer, which showed a 2 × 2 × 3.4-cm cystic lesion in the uncinate process of the pancreas (Figure 1). Abdominal MRI confirmed a 3.7 × 2.3-cm pancreatic lesion. A magnetic resonance cholangiopancreatography was performed due to worrisome features including a size greater than 3 cm and growth of ≥2.5 mm per year;2 this showed a stable cystic lesion with no internal septation or solid component (Figure 1). The patient underwent endoscopic ultrasound with fine needle aspiration. The cyst was described as an anechoic, single compartment fluid-filled cavity with no debris. Approximately 15 mL of milky white fluid was aspirated (Figure 2). Analysis showed chronic inflammatory cells in a background of acellular debris and gastrointestinal contaminant with no malignant cells. The aspirate showed carcinoembryonic antigen (CEA) 6.6 ng/mL, amylase 552 U/L, and triglycerides 8,457 mg/dL, diagnostic for pancreatic lymphangioma.3Figure 1.: Pancreatic lesion on MRI.Figure 2.: Aspirated fluid from cyst.DISCLOSURES Author contributions: VW Ouyang: data collection, data interpretation, and writing of manuscript. DT Gildea: data interpretation and writing of manuscript. ST Frost: editing of manuscript. D. BouHaidar: editing of manuscript and is the article guarantor. Financial disclosure: None to report. Informed consent was obtained for this case report.