Pediatric Chylo Lymphatic Mesentric Cyst
A Rare Entity
DOI:
https://doi.org/10.21276/apalm.1957Keywords:
Neonate, chylous cyst, mesentery, histopathology.Abstract
Chylolymphatic cysts are rare variants of mesenteric lesions constituting 7.3% to 9.5% of all abdominal cysts displaying variable presentation and having surgical implications in the pediatric age group. The preoperative imaging studies are suggestive however histopathological examination remains the gold standard for diagnosis. A two months old male child was admitted with complaints of bilious vomiting for three days which was initially nonbilious in nature.
There were no other significant medical or surgical complaints. X ray abdomen showed evidence
of intestinal obstruction.Ultrasound revealed a large cystic lesion in abdominal cavity with
internal echos arising from the ileal mesentery on ultrasonography. Subsequently exploratory
laparotomy with excision of ileal segment involved by cyst and ileoileal anastomosis was
performed and cyst was sent for histopathological examination. On syringing milky white fluid
was aspirated which on biochemical analysis confirmed the chylous nature. The
histopathological examination revealed an unilocular cyst having a fibrous wall infiltrated by
lymphocytes and macrophages and lined by single layer of flattened epithelium with few dilated
lymphatic channels consistent with chylolymphatic cyst. Although vary rare, chylomesenteric
cyst should be kept as one of the differential diagnosis of cystic masses of the abdomen.
References
2. Egozi EI, Ricketts RR. Mesenteric and omental cysts in children. Am Surg. 1997;63:287e290.
3. Gupta AR, Nanavati RN, Fernandez AR, Kalgutkar A, Nathani R, Deshmukh SS. Chylous mesenteric cyst: An unusual cause of neonatal intestinal obstruction. Indian Pediatr 1992;29:511‑3.
4. Doreen L.P.Lee et al.Chylous mesenteric cyst: A diagnostic dilemma. Asian journal of Surgery 2016:39,182-186.
5. Chung MA, Brandt ML, St‑Vil D, Yazbeck S. Mesenteric cysts in children. J Pediatr Surg 1991;26:1306‑8.
6. Fujita N, Noda Y, Kobayashi G, Kimura K, Watanabe H, Masu K, et al. Chylous cyst of the mesentery: US and CT diagnosis. Abdom Imaging 1995;20:259‑61.
7.Nakamura H, Hashimoto T, Akashi H, Mizumoto S. Distinctive CT‑findings of unusual mesenteric cysts. J Comput Assist Tomogr 1987;11:1024‑5.
8.Rattan KN, Yadav S, Chhabra S, Rattan A. A giant chylolymphatic cyst presenting as intestinal obstruction in a neonate. Onc Gas Hep Rep 2016;5:16-8.
9. Kurtz RJ, Heimann TM, Holt J, Beck AR. Mesenteric and retroperitoneal cysts. Ann Surg. 1986;203:109-2.
10.Rattan KN, Nair VJ, Pathak M, Kumar S. Pediatric chylolymphatic mesenteric cyst - a separate entity from cystic lymphangioma: a case series. J Med Case Reports. 2009;3:111.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Rachana Swapnil Binayke, Shubhangi V Agale, Banasri Devi, Pinkesh Gugaliya, Grace F D’Costa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
