Hepatic lymphangioma in a neonate: A rare case report

Lymphangiomas are benign neoplasms regarded as congenital malformations of the lymphatic system, composed of dilated endothelial lined spaces of varying sizes containing lymph. Most lymphangiomas (95%) are located in the neck or the axilla. Intra -abdominal cases account for less than 5% of all lymphangiomas, mainly mesenteric or retroperitoneal. Here we have a rare case of hepatic lymphangioma, which presented as an intra-abdominal mass and diagnosed to be congenital hepatic cyst or off-centered mesenteric cyst in NCCT and USG respectively, which was then confirmed to be arising from the liver intraoperatively. Microscopy showed multiple cystic spaces lined by flattened epithelium, for which the differential diagnosis of simple mesothelial cyst and lymphangioma was offered, which was then confirmed by IHC which showed D2-40 positivity and Calretinin negativity. Hepatic lymphangioma which was difficult to be diagnosed definitively prior to surgery. Here, morphological study and IHC turned out to be useful in arriving at definitive diagnosis.