Gastrointestinal tract lymphangiomas: findings at CT and endoscopic imaging with histopathologic correlation

To evaluate and describe CT and endoscopic imaging findings in patients with pathologically confirmed gastrointestinal tract lymphangiomas.

Findings from imaging examinations in 6 patients with pathologically confirmed lymphangioma were retrospectively reviewed (computed tomographic images obtained in 6 patients and endoscopic images obtained in 4 patients were available for review). Two radiologists evaluated lesion location, size, shape, edge, number, attenuation, the thickness of capsule wall and the degree of enhancement through PACS or workstation.

Lymphangiomas in gastrointestinal tract showed similar features in CT imaging: Contrast-enhanced CT scan showed the oval submucosal masses with homogeneous low attenuation. The lymphangioma appeared as a well-defined, smoothly marginated and non-enhancing cystic mass with intact overlying intestinal mucosa. In one case, the lymphangiomas were multiple with volvulus. Remarkably, CT imaging showed 2 patients with intussusception due to the mass. Endoscopic photographs manifested multiple colplanate mucosal protrusions in the gastric wall or intestinal wall. One case showed submucosal pedunculated proliferative lesion with adenomatous surface.

Lymphangiomas exhibited typical appearances that reflected their cystic pathologic features. They showed similar features in CT imaging: well-demarcated, non-enhancing, homogeneous low attenuation cystic masses with intact overlying mucosa. Endoscopic photographs showed submucosal masses with distension of overlying mucosal vessels.