DOI: 10.1148/rg.234025123
Best Cases from the AFIP
Omental Lymphangioma with Small-Bowel Volvulus1
Colin R. Mar, MD,
Chitra Pushpanathan, MD,
David Price, MD and
Benvon Cramer, MD
1 From the Departments of Diagnostic Imaging (C.R.M., B.C.), Pathology (C.P.), and Surgery (D.P.), Janeway Children’s Health and Rehabilitation Centre, St John’s, Newfoundland, Canada. Received July 11, 2002; revision requested August 20 and received September 19; accepted September 23. Address correspondence to C.R.M., Department of Diagnostic Radiology, Memorial University of Newfoundland, Health Sciences Centre, 300 Prince Philip Dr, St John’s, Newfoundland, Canada A1B 3V6 (e-mail: cmar72@hotmail.com).
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Figure 1a. Supine (a) and erect (b) radiographs of the abdomen show multiple dilated loops of small intestine in the upper abdomen. There is no evidence of a soft-tissue mass.
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Figure 1b. Supine (a) and erect (b) radiographs of the abdomen show multiple dilated loops of small intestine in the upper abdomen. There is no evidence of a soft-tissue mass.
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Figure 2a. (a) US image shows a bilobed cystic mass with low-grade internal echoes. (b) US image obtained superior to a shows a segment of dilated small intestine in addition to free intraperitoneal fluid.
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Figure 2b. (a) US image shows a bilobed cystic mass with low-grade internal echoes. (b) US image obtained superior to a shows a segment of dilated small intestine in addition to free intraperitoneal fluid.
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Figure 3a. CT images obtained with intravenously administered contrast material (a obtained at a higher level than b) show the mesentery swirling around the superior mesenteric artery and superior mesenteric vein as a result of small-bowel volvulus. Multiple loops of dilated small intestine are seen, one of which is closely associated with the superior aspect of the bilobed cystic mass in the left hemiabdomen.
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Figure 3b. CT images obtained with intravenously administered contrast material (a obtained at a higher level than b) show the mesentery swirling around the superior mesenteric artery and superior mesenteric vein as a result of small-bowel volvulus. Multiple loops of dilated small intestine are seen, one of which is closely associated with the superior aspect of the bilobed cystic mass in the left hemiabdomen.
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Figure 4a. (a) Photograph of the gross specimen shows that the cyst is multiloculated with a short segment of small intestine plastered to its surface. There is no communication between the intestine and the cyst. (b) Photograph of the bisected mass shows a good correlation with the US and CT appearances. The walls of the two large loculi are thin and semitransparent.
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Figure 4b. (a) Photograph of the gross specimen shows that the cyst is multiloculated with a short segment of small intestine plastered to its surface. There is no communication between the intestine and the cyst. (b) Photograph of the bisected mass shows a good correlation with the US and CT appearances. The walls of the two large loculi are thin and semitransparent.
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Figure 5. Photomicrograph (original magnification, x2; hematoxylin-eosin stain) of a representative section of one of the large loculi shows an attenuated lining and a fibromuscular wall with scattered lymphocytes. The adjacent fibrofatty stroma contains dilated lymphatics.
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Copyright © 2003 by the Radiological Society of North America.
