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.