Adult Colonic Lymphangioma presenting as Intussuseption

A Rare Case Report

Abstract

Background: Lymphangiomas are rare benign neoplasms of lymphatic origin mostly occurring in the neck and axillary region. Gastrointestinal involvement is uncommon, with colonic localisation representing an exceptionally rare occurrence, particularly in adults.

Case Presentation: We report the case of a 78-year-old female presenting with abdominal pain for two days. Ultrasound (USG) abdomen revealed a large ileocolic intussusception in the infraumbilical region. Contrast-enhanced computed tomography (CECT)-Abdomen revealed an intramural, low-density, multilocular mass with a low-contrast-enhanced wall and internal septations located in the ascending colon. Right hemicolectomy was performed which revealed ileocolic intussusception along with a large grey-brown polypoidal mass in the ascending colon and cecum measuring 5 x 4.5 cm. Cut section through the mass was grey-brown with areas of haemorrhage. Histopathology revealed thin-walled lymphatic channels lined by flattened benign endothelial cells and containing eosinophilic proteinaceous fluid and occasional lymphocytes, consistent with submucosal lymphangioma.

Conclusion: Colonic lymphangiomas are rare benign lesions with nonspecific clinical manifestations. Imaging techniques can assist in identifying the lesions, but microscopic evaluation is necessary for confirmation. Complete surgical excision is curative and associated with excellent prognosis.