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Colonic cystic lymphangioma
COLONIC CYSTIC LYMPHANGIOMA
A 34-year-old man was referred because of two episodes of hematochezia over a 6-week period. There was no abdominal pain or change in bowel habit. Colonoscopy revealed a bluish submucosal tumor in the transverse colon just proximal to the splenic flexure (A). Probing with a closed biopsy forceps produced an indentation in a ‘‘balloon-like’’ fashion. EUS with a 20-MHz catheter probe demonstrated a 2.1 3 1.8-cm cystic structure with an irregular wall and two internal septations (B). The lesion was completely resected by electrosurgical snare polypectomy. On histopathologic evaluation of the resection specimen, the submucosa was mark-
98
GASTROINTESTINAL ENDOSCOPY
edly expanded by the presence of irregularly shaped and dilated channels (C, arrows; H&E, orig. mag. 31) lined by flattened endothelial cells and smooth muscle. A diagnosis of lymphangioma of the colon was made. The patient has had no further symptoms. Glen M. Arluk, MD Cinthia Drachenberg, MD Peter Darwin, MD University of Maryland Medical Center Baltimore, Maryland PII: S0016-5107(04)01294-5
VOLUME 60, NO. 1, 2004
A 34-year-old man was referred because of two episodes of hematochezia over a 6-week period. There was no abdominal pain or change in bowel habit. Colonoscopy revealed a bluish submucosal tumor in the transverse colon just proximal to the splenic flexure (A). Probing with a closed biopsy forceps produced an indentation in a ‘‘balloon-like’’ fashion. EUS with a 20-MHz catheter probe demonstrated a 2.1 3 1.8-cm cystic structure with an irregular wall and two internal septations (B). The lesion was completely resected by electrosurgical snare polypectomy. On histopathologic evaluation of the resection specimen, the submucosa was mark-
98
GASTROINTESTINAL ENDOSCOPY
edly expanded by the presence of irregularly shaped and dilated channels (C, arrows; H&E, orig. mag. 31) lined by flattened endothelial cells and smooth muscle. A diagnosis of lymphangioma of the colon was made. The patient has had no further symptoms. Glen M. Arluk, MD Cinthia Drachenberg, MD Peter Darwin, MD University of Maryland Medical Center Baltimore, Maryland PII: S0016-5107(04)01294-5
VOLUME 60, NO. 1, 2004