Pathological Discrepancy: Simple Mesenteric Cyst vs. Mesenteric Lymphangioma

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Mesenteric cysts and cystic lymphangiomas present similarly but have distinct histological features.
• Accurate differentiation is essential for appropriate patient management.

Observation:

• A 52-year-old woman presented with a palpable abdominal mass.
• Imaging revealed a large sigmoid colon mesenteric cyst (13x11x10 cm).
• Initial pathology suggested a mesothelial cyst, but immunohistochemistry confirmed mesenteric cystic lymphangioma.

Findings:

• Mesenteric cystic lymphangioma is a rare entity, with fewer than 200 cases reported.
• While typically seen in younger individuals, it can occur in adults.
• Histopathological examination, including immunohistochemistry, is definitive for diagnosis.

Implications:

• This case highlights the importance of considering mesenteric cystic lymphangioma in adult abdominal masses.
• Enhanced awareness among clinicians is necessary for timely diagnosis and treatment.
• Definitive diagnosis relies on histopathological analysis to distinguish from other cystic lesions.