PMC9887134_01
Abdominal enhanced CT axial arterial phase (A), coronary arterial phase (B), axial venous phase (C),and sagittal arterial phase (D) CT images show a retroperitoneal cystic mass (white solid arrow), extending along the mesentery to 24 cm. The tumor oppresses the surrounding intestine (blue solid arrow) and the inferior vena cava (B) (red solid arrow).
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F1
Abdominal enhanced CT: huge cystic space in the pelvis and abdominal cavity, with an irregular shape, linear septum, (approximately 24.2 cm x 16.7 cm x 27.8 cm), extending along the mesentery of the small intestine (Figures 1A-D). In contrast-enhanced scan, the cystic components were not enhanced, the septum was uniformly enhanced, the intestinal canal was displaced laterally under pressure (Figures 1A, Magi B), and the inferior vena cava was narrowed (Figure 1C).
Image of the gross specimen.
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F2
We decided to surgically remove the cystic mass completely (Figure 2).
Necrosis and protein exudation in the cystic cavity, obvious proliferation of interstitial vessels and fibrous tissue, cystic lymphatic cavities of different sizes with inflammatory lymphocyte infiltration and lymphoid nodules; (A) hematoxylin and eosin (HE) x 40, scale 500 mum; (B) HE x 100, scale 200 mum.
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F3
Postoperative pathology: microscopically, necrosis and protein exudation in the cystic cavity, chronic inflammation with inflammatory granulation, obvious proliferation of interstitial vessels and fibrous tissue, scattered in clusters of smooth muscle bundles and more inflammatory cells, and occasional giant cells, as well as proliferation of small lymphatic vessels outside the cyst wall, consistent with cystic lymphangioma with chronic inflammation (Figures 3A,B).