Mesenteric and omental cysts: histologic classification with imaging correlation

Forty-one cases of mesenteric and omental cysts are reported. Histologically, several specific types could be distinguished: lymphangioma, 19 cases; nonpancreatic pseudocyst, 11 cases; enteric duplication cyst, six cases; mesothelial cyst, three cases; and enteric cyst, two cases. A lymphangioma is usually a multiloculated cyst located in the mesentery that shows no discernible wall on computed tomography (CT) and may have characteristics of fat on CT and magnetic resonance imaging. Abnormalities in the small bowel mucosa were frequently noted on barium studies. A nonpancreatic pseudocyst is usually a unilocular or multilocular cyst located in either the mesentery or the omentum, with abundant debris sonographically and an enhancing wall on CT. An enteric duplication cyst is a unilocular cyst with an enhancing wall on CT. Mesothelial and enteric cysts are anechoic, thin-walled cysts. Emphasis is placed on the importance of identifying lymphangioma, which is more difficult to manage than the other forms of mesenteric and omental cysts.