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obsolete intra-abdominal lymphangioma
Description
Obsolescence of Intra-Abdominal Lymphangioma Terminology
The term "lymphangioma" has been deemed outdated and incorrect by medical professionals, as it suggests a tumor when in fact it is a developmental malformation, not a tumor [12]. This change in terminology reflects the understanding that lymphangiomas are benign, congenital malformations of the lymphatic system, rather than neoplastic growths.
Characteristics of Intra-Abdominal Lymphangioma
Intra-abdominal lymphangiomas are rare, usually occurring below the diaphragm. They can occur in any part of the intestinal tract and even in the mesentery, retroperitoneum, and abdominal wall [9]. These malformations are typically benign and slow-growing, with a prevalence that is equal between males and females.
Historical Context
The historical background of intra-abdominal lymphangiomas has been reviewed, highlighting their clinical features, radiographic findings, and treatment options. The condition may give rise to acute surgical abdomen, emphasizing the importance of complex imaging studies in their evaluation [4].
Current Understanding
Intra-abdominal cystic and cavernous lymphangiomas are now recognized as rare benign tumors that usually appear incidentally through lymphangiography or during elective abdominal surgery [14]. The malformation is believed to arise from sequestration of lymphatic tissue that fails to communicate with lymphatic flow, or from developmental anomalies [15].
References
[12] ZB Niu. (2011). The term "lymphangioma" is outdated and incorrect. Cited by 2. [14] Intra-abdominal cystic and cavernous lymphangiomas are rare benign tumours, usually found incidentally through lymphangi- ography, during elective abdominal surgery. [15] M DI MARCO. (2016). The malformation appears to arise from sequestration of lymphatic tissue that fails to communicate with lymphatic flow, or from developmental anomalies. Cited by 23.
Additional Characteristics
- Intra-abdominal lymphangiomas are rare, benign, congenital malformations of the lymphatic system.
- They can occur in any part of the intestinal tract and even in the mesentery, retroperitoneum, and abdominal wall.
- The condition is usually slow-growing and has an equal prevalence between males and females.
- Intra-abdominal cystic and cavernous lymphangiomas are now recognized as rare benign tumors that may appear incidentally or during elective surgery.
- The malformation arises from sequestration of lymphatic tissue or developmental anomalies.
Signs and Symptoms
Common Signs and Symptoms of Intra-Abdominal Lymphangioma
Intra-abdominal lymphangiomas are rare and can manifest in various ways, making diagnosis challenging. The clinical presentation may vary depending on the location and size of the tumor.
- Abdominal Pain: A common symptom, which can range from mild to severe, is abdominal pain (1, 2, 5, 7). This pain can be chronic or acute, depending on the situation.
- Incidentally Identified Mass: An abdominal mass may be discovered incidentally during a medical examination or imaging test (1, 2, 4).
- Abdominal Distension: Abdominal distension is another common symptom, which can occur due to the accumulation of fluid within the cystic lymphangioma (3, 7).
- Nausea and Vomiting: Some patients may experience nausea and vomiting, especially if the tumor is causing intestinal obstruction or volvulus (12).
Less Common Symptoms
In addition to these common symptoms, some patients may also experience:
- Weight Loss: Unintentional weight loss can occur due to malabsorption or decreased appetite (10).
- Bowel Obstruction: Intestinal obstruction or volvulus can cause severe abdominal pain, vomiting, and constipation (12).
- Volvulus: A twisting of the intestines, which can lead to bowel obstruction and ischemia (12).
Imaging Modalities
Imaging modalities play a crucial role in diagnosing intra-abdominal lymphangiomas. CT scans are commonly used to visualize the cystic lesion, although diagnosis may not be made preoperatively in all cases (15).
Diagnostic Tests
Diagnostic Tests for Intra-Abdominal Lymphangioma
Intra-abdominal lymphangiomas are rare and complex lesions that can be challenging to diagnose using imaging modalities alone. The following diagnostic tests have been used in the past to aid in the diagnosis of intra-abdominal lymphangioma:
- Ultrasonography: This is often the primary diagnostic modality for showing the size, location, and content of cysts in relation to surrounding tissues [1]. However, it may not be sufficient to differentiate lymphangiomas from other fluid-containing masses and ascites in the abdomen.
- Computed Tomography (CT): CT scans can help in differentiating large abdominal lymphangioma from ascites [10]. However, they may not provide enough information for a definitive diagnosis.
- Magnetic Resonance Imaging (MRI): MRI studies are helpful for diagnosis and surgical planning of abdominal cyst lymphangioma but may not be widely available or necessary for all cases [4].
- Endoscopic or Excisional Biopsy: The diagnosis of lymphangioma was made on histopathology from either endoscopic or excisional biopsy of the lesion [3]. This is considered the gold standard for diagnosis.
Limitations and Challenges
The differential diagnosis of intra-abdominal lymphangioma includes many benign and malignant tumors, making it a complex diagnostic challenge. Imaging tests such as ultrasound and tomography may not be sufficient to rule out other conditions, and further differential diagnostic workup may be necessary [7].
Current Recommendations
While the above diagnostic tests have been used in the past, current recommendations suggest that imaging modalities should be used in conjunction with histopathological examination for a definitive diagnosis. Surgical excision is often considered the treatment of choice for intra-abdominal lymphangioma.
References:
[1] Shayesteh S (2021) Ultrasonography in the diagnosis of cysts in relation to surrounding tissues [2]
[3] Mede A (2023) Diagnosis of lymphangioma on histopathology from endoscopic or excisional biopsy [3]
[4] Candussi IL (2024) Ultrasonography, computed tomography, and magnetic resonance imaging studies for diagnosis and surgical planning of abdominal cyst lymphangioma [4]
[7] Guachilema Ribadeneira A (2020) Imaging tests used are the ultrasound and tomography, which determine the therapeutic behavior. The differential diagnosis should be made with other intra-abdominal injuries [7]
Note: The above response is based on the provided context and search results.
Additional Diagnostic Tests
- Computed Tomography (CT)
- Magnetic Resonance Imaging (MRI)
- Ultrasonography
- Endoscopic or Excisional Biopsy
Treatment
Based on the provided context, it appears that there are various treatment options available for intra-abdominal lymphangiomas, including drug treatments.
- Sclerotherapy: This is a minimally invasive procedure where a medication is injected directly into the lymphangioma to cause scarring and shrinkage of the tumor. According to search result [6], intralesional sclerotherapy is generally regarded as an adjuvant treatment for intra-abdominal lymphatic malformations (LMs).
- Doxycycline: This antibiotic has been used as a primary sclerosing agent in treating macrocystic intraabdominal LMs. Search result [7] indicates that doxycycline was used to treat patients with this condition, and the results showed it to be a safe and effective procedure.
- Bleomycin: This chemotherapy medication has been used to treat various types of lymphangiomas, including intra-abdominal forms. According to search result [8], research indicates that intralesional bleomycin is effective in treating these conditions.
It's worth noting that while drug treatments may be an option for some patients with intra-abdominal lymphangiomas, surgery and sclerotherapy are also commonly used treatment options (search results [3] and [4]).
References: [6] Ono H. (2022) [7] Russell KW. (2014) [8] Özcan R. (2023)
Recommended Medications
- Sclerotherapy
- doxycycline
- Doxycycline
- bleomycin
- Bleomycin
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
Based on the provided context, it appears that intra-abdominal lymphangiomas are rare and can be challenging to diagnose. The differential diagnosis for this condition includes a range of possibilities.
Possible Differential Diagnoses:
- Bile duct cysts [1]
- Polycystic liver disease [1]
- Cystic metastasis [1]
- Echinococcal cysts [1]
- Mesenchymal tumors [4, 8]
Additionally, the differential diagnosis for intra-abdominal lymphangiomas may also include:
- Macrocytic or mixed fat and fluid density abdominal mass [2, 3]
- Benign and malignant tumors [12]
- Meconium peritonitis [4]
- Meconium cyst [4]
- Bowel obstruction secondary to other causes [4]
It's worth noting that the diagnosis of intra-abdominal lymphangiomas can be complex and may require a combination of imaging studies, such as ultrasonography and computed tomography, along with clinical evaluation.
References:
[1] Levy AD. (2004) - The differential diagnosis for hepatic lymphangiomas includes bile duct cysts, polycystic liver disease, cystic metastasis, echinococcal cysts, and mesenchymal tumors. [2] Shayesteh S. (2021) - Although intra-abdominal lymphangioma is extremely rare, it should be considered among the differential diagnoses of macrocystic or mixed fat and fluid density abdominal mass. [3] Shayesteh S. (2021) - Although intra-abdominal lymphangioma is extremely rare, it should be considered among the differential diagnoses of macrocystic or mixed fat and fluid density abdominal mass. [4] Chew BJW. (2019) - The differential diagnosis based on this antenatal scan was lymphangioma, mesenteric cyst, meconium peritonitis, meconium cyst, or bowel obstruction secondary to other causes. [8] Hager J. (2014) - After having completed the differential diagnostic workup, the most likely diagnosis remained an ICL so that surgical intervention to remove the ... [12] Ultrasonography and computed tomography are very sensitive but not very specific examinations. The differential diagnosis of intra-abdominal lymphangioma includes many benign and malignant tumors.
Additional Differential Diagnoses
- Meconium peritonitis
- Mesenchymal tumors
- Benign and malignant tumors
- Bile duct cysts
- Cystic metastasis
- Echinococcal cysts
- Macrocytic or mixed fat and fluid density abdominal mass
- Meconium cyst
- Bowel obstruction secondary to other causes
- polycystic liver disease
Additional Information
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- http://www.w3.org/2002/07/owl#Class
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