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Background Lymphangiomas are benign vascular tumors arising from the lymphatic system. They commonly affect the head and neck regions. Pancreatic involvement is extremely rare. Even though they are rare, it should be considered as a differential diagnosis for patients who present with pancreatic mass. Case presentation We report the case of a 6-year-old African male patient who presented with abdominal mass and dull aching pain of 6 months duration. He was examined and underwent excision, with biopsy showing pancreatic lymphangioma. Conclusion These tumors are benign and slow growing and have potential to regress spontaneously. Thus, most literature agrees that surgical interventions should be reserved for symptomatic cases.

Abstract A 2-year-old Border Collie presented with watery diarrhea and weight loss. Laboratory testing disclosed hypoproteinemia and abdominal imaging identified striations suggestive of intestinal lymphangiectasia and a polycystic mass contiguous with the pancreas. Clinical signs were transiently ameliorated by using prednisolone at an anti-inflammatory dosage, but hypoproteinemia recurred accompanied by ascites within 1 month. Exploratory laparotomy identified pancreatic cysts and extensive inflammation of the duodenum and jejunum, and biopsy samples were taken for histopathology. The pancreatic cyst was lined by lymphatic vessels with no atypia and surrounding collagen fibers, highly suggestive of pancreatic lymphangioma. Histopathology of jejunal biopsy samples disclosed lipogranulomatous lymphangitis and lymphangiectasia. After the laparotomy, the dog was treated with prednisolone at a physiologic dosage and a low-fat diet, and remained asymptomatic for 1 year.

Lymphangiomas are comprised of aggregates of lymphatic vessels, considered to represent either aberrant embryogenic remnants or developing secondary to obstruction. Lymphangiomas primary to the heart and pericardial are exceedingly rare, and to date sparingly reported in individual case reports. In this study, the histopathologic, clinical, and radiologic features of 35 cases of cardiac/pericardial lymphangiomas described in the literature to date together with four cases from our own institution (39 cases in total) are examined to provide clinicopathologic characterization. Cardiac/pericardial lymphangiomas were identified in both children and adults, with two cases initially discovered in utero. If presenting with symptoms, patients most commonly exhibited respiratory distress/dyspnea. By X-ray, a widened cardiac silhouette could be noted, and echocardiogram generally showed an echogenic mass with cystic and septal components. On computed tomography (CT) and magnetic resonance imaging (MRI), cystic and septal components were again observed, with CT showing an absence of calcifications or macroscopic fat. Most lymphangiomas were pericardial (specifically visceral) based, and frequently situated in the right atrioventricular groove. A majority of cases proceeded to surgical resection, with no evidence of recurrence post-operatively. Grossly, lesions had a median size of 6 cm and in almost all cases were multicystic/multilocular. Microscopically, the lymphangiomas were composed of lymphatic spaces lined by endothelial cells that specifically express podoplanin (D2-40) with immunoperoxidase staining. Further investigation with a larger and more uniformly organized cohort is required to better characterize the clinicopathologic features of lymphangiomas of this unusual anatomic location.

Background Lymphangiomatous lesions commonly occur in the head and neck region; however, involvement of the palatine tonsil is rare. Tonsillar lymphangiomatous polyps containing both adipose tissue and smooth muscle proliferation are exceptionally uncommon. We report a rare case of tonsillar lymphangioma with adipose tissue and focal smooth muscle proliferation. Case presentation A 28-year-old Iranian man presented with sore throat and was found to have a pedunculated mass arising from the right palatine tonsil. Physical examination revealed a smooth-surfaced, non-ulcerated polypoid lesion measuring 2 × 1 × 0.3 cm. Owing to the small size and clinically benign appearance of the lesion, no preoperative imaging was performed. Right-sided tonsillectomy was undertaken. Histopathologic examination demonstrated a lymphangiomatous polyp (lymphangioma) composed of dilated lymphatic channels within a fibroadipose stroma with focal smooth muscle proliferation. The lesion was completely excised with negative surgical margins. No recurrence was observed during 1 year of follow-up. Conclusions Tonsillar lymphangiomatous lesions are rare benign entities that may clinically mimic other tonsillar masses. Histopathologic examination is essential for definitive diagnosis. Complete surgical excision appears curative, and recurrence is uncommon.

Salivary gland neoplasms are uncommon, and most exhibit epithelial differentiation. Mesenchymal neoplasms of the salivary gland are rare, and the incidence ranges from 1.9% to 5%. The aim of this study is to identify the types and clinical-pathological features of mesenchymal salivary neoplasm and review their differential diagnosis. A retrospective search for mesenchymal neoplasms of salivary glands from our institution's pathology archives from the 2004–2021 period and consultation files of one of the authors (AER) was performed. The clinical data were obtained from available medical records, and the histological slides and ancillary studies were retrieved and reviewed. We identified a total of 68 cases that form the study cohort. Thirty-five patients were male, and thirty-three patients were female, with a mean age of 48 years (range, 7 months–79 years), and the male to female ratio was 1:.94. Sixty-three (92.6%) of sixty-eight tumors were benign and included: 38 (56%) lipomas, 9 (13%) hemangiomas, 7 (10.3%) schwannomas, 3 (4.4%) neurofibromas, 3 (4.4%) lymphangioma, 2 (3%) solitary fibrous tumors, 1 (1.5%) myofibroma. Five of sixty-eight (7.4%) were malignant and included: 3 (4.4%) Adamantinoma-like Ewing sarcomas, 1 (1.5%) malignant peripheral nerve sheath tumor (MPNST), and 1 (1.5%) malignant solitary fibrous tumor. The involved sites included: parotid (55), submandibular gland (5), parapharyngeal space (5), buccal mucosa minor salivary gland (2), and sublingual gland (1). Sixty-seven patients underwent surgical resection. One patient with lymphangioma manifested a recurrence/persistence a week post-surgery. One patient with a parotid hemangioma developed post-operative numbness, and another patient developed chronic postauricular pain after surgery. Two patients with MPNST and one patient with adamantinoma-like Ewing sarcoma underwent neoadjuvant chemoradiation and were disease-free after treatment. The remaining 37 patients with available follow-up ranging from 7 days to 96 months (mean, 18 months) had a favorable outcome and were disease-free after treatment. Mesenchymal neoplasms of salivary gland are rare; most are benign and demonstrate adipocytic, endothelial, and schwannian differentiation; awareness of their development is important for adequate diagnosis. The mainstay of treatment is surgical excision, with the extent determined by tumor type. Adjuvant therapy is reserved for high-grade sarcomas and may be given in a neoadjuvant or adjuvant setting.

Lymphangioma insults in adults are uncommon and the occurrence in the oropharynx is extremely rare. Although disease history and clinical symptoms may help in distinguishing it from malignant tumors, the pathophysiology of lymphangioma via histological examinations should be established for convenient and precise diagnosis. We present a 20-year-old male with lymphangioma in the right oropharynx, and the multiple-angle examination and treatment plan used. The case further emphasizes the need to consider lymphangioma in the differential diagnosis of an oropharyngeal mass. Awareness that lymphangioma can occur in adults is important for its proper management, which includes complete surgical removal to prevent recurrence.

Background Urinary bladder lymphangioma is a rare and benign lesion that is often causes symptoms related to irritation and urinary tract obstruction. Because a lymphangioma may resemble a true neoplasm of the urinary bladder clinically, the lesion must be removed for accurate histologic diagnosis and to rule out malignancy. Case presentation We present a case of a 40-year-old female who was evaluated for painless gross hematuria. Clinical and diagnostic work up revealed a sharply defined mass involving the wall and bulging into the cavity on the dome of the bladder. Partial cystectomy was performed and histologic findings were compatible with cavernous lymphangioma. The symptom of hematuria relieved after the procedure and the patient was in good status without evidence of recurrence by cystoscopy at follow-up 6 months later. Conclusions Lymphangioma of the urinary bladder is treated with surgical excision and seems to have no recurrence once completely resected, but long-time follow-up may be needed.