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Lymphangioma Presents as Peripancreatic Cystic Neoplasm: The Utility of Endoscopic Ultrasound

Heather Pemberton, Mohamed Sultan, Walid Chalhoub, Shannon Morales, Mohammed Al-Bugeay, Jill Smith and Nadim Haddad

Pancreatic lymphangiomas are very rare benign cystic lesions that arise from abnormal proliferation of the lymphatic vessels. Although benign, pancreatic lymphangiomas may mimic more concerning cystic neoplasms and therefore require a thorough diagnostic workup. Herein we report a case of a 50-year-old female who presented with a peripancreatic cyst measuring 2.5x3.6x4.7cm that was discovered incidentally during an abdominal ultrasound. She underwent endoscopic ultrasound with fine needle aspiration where chylous fluid was drained. Cytology was negative for malignancy and fluid chemistry demonstrated a significantly elevated triglyceride level consistent with a pancreatic lymphangioma. It is unclear whether asymptomatic pancreatic lymphangiomas are best managed conservatively or with surgical intervention. The patient has not proceeded with surgery at this time.