Cystic pancreatic lymphangioma. The first report of a preoperative pathological diagnosis by endoscopic ultrasound-guided cyst aspiration.

CONTEXT: We describe a case of cystic lymphangioma of the pancreas in which a preoperative tissue diagnosis was made with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA).

CASE REPORT: A 20-year-old female presented with upper abdominal pain of two months duration and was found to have a cystic lesion in the pancreatic tail. Radiological imaging could not determine the organ of origin or the nature of the lesion. On EUS examination, a mixed micro-macrocystic lesion with thin delicate septae, and clear anechoic contents was found in the pancreatic tail. EUS-guided aspiration demonstrated the typical endothelial lined cystic channels. The diagnosis was confirmed after surgical resection.

CONCLUSION: Cystic lymphangioma should be considered in the differential diagnosis of cystic pancreatic lesions in which the morphology is difficult to characterize. EUS-FNA has the potential of rendering a positive diagnosis of this benign entity.