PMC7653000_01
Abdominal computed tomography (CT) and magnetic resonance imaging (MRI).. (A) Contrast-enhanced CT shows a cystic lesion arising from the processus uncinatus of the pancreas and the root of the superior mesenteric artery (arrowhead). The lesion is being supplied by the second branch (arrow) of the superior mesenteric artery.. (B) The cystic wall and septa are enhanced by the contrast medium.. (C) Coronal T2-weighted MRI shows hyperintense, huge, multiple, cystic lesions displacing the small intestine upwards (arrows).
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It extended up to the pelvis and displaced the small intestine upwards (Fig. 1). Abdominal magnetic resonance imaging (MRI) showed hypointense T1- and hyperintense T2-weighted multiple cystic lesions (Fig. 1).
Intraoperative findings during the patient's laparotomy.. The peritoneal cavity is fully occupied by a multi-cystic lesion arising from the root of the jejunal mesentery. It predominantly contains a clear yellowish fluid.
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It was adherent to the transverse mesocolon and duodenum (Fig. 2).
Macroscopic examination of the multi-cystic lesion.. (A) The formalin-fixed specimen shows a huge, 22 x 21 x 8 cm, polycystic lesion adherent to the processus uncinatus of the pancreas.. (B) The cut section reveals that the tumor consists of multiple cysts which vary in size, from 1 mm to 10 cm. Arrow: processus uncinatus of the pancreas.
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Macroscopically, a huge, 22 x 21 x 8 cm, yellowish, multi-cystic lesion was observed (Fig. 3).
Microscopic examination of the multi-cystic lesion.. (A) The processus uncinatus of the pancreas is seen adjacent to a lymphangioma (Hematoxylin & Eosin, loupe).. Arrow: a portion of the lymphangioma; Star: processus uncinatus of the pancreas.. (B) The lesion is composed of multiple loculi; each locule has an irregularly dilated space separated by fibrous tissues and smooth muscle fascicles. The wall of the cyst is lined by a flat endothelial layer (Hematoxylin & Eosin, x13).. (C) Immunohistochemical staining shows that the epithelium covering the cysts is positive for D2-40 (x40).
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The wall of the cyst was lined by a flat endothelial layer (Fig. 4).