腹腔鏡下に完全切除した小網リンパ管腫の1例

A case of laparoscopically resected lymphangioma of the lesser omentum

◆要旨：症例は32歳，女性．腹部違和感，食欲不振を主訴に近医を受診した．腹部超音波検査で上腹部に囊胞性病変を指摘され，当院を紹介された．腹部CT検査で肝左葉，膵上縁および胃小彎に囲まれた領域に約10cm大の囊胞性病変を認めた．内部は均一な低吸収域を呈し，充実成分は認めなかった．MRI検査で膵管との交通はなく，超音波内視鏡検査で多囊胞性成分を認めた．以上の所見より小網由来の囊胞性リンパ管腫と診断し，腹腔鏡下小網腫瘍摘出術を施行した．病理組織学的には囊胞性リンパ管腫の像を呈していた．小網由来の囊胞性リンパ管腫は稀であり，また腹腔鏡下に安全に切除しえたため，文献的考察を加えて報告する．

　The case involves a 32-year-old woman who visited her local doctor with a chief complaint of abdominal discomfort and lack of appetite. A cystic lesion in her upper abdomen was noted on abdominal ultrasonography, following which she was referred to our hospital. Abdominal computed tomography （CT）confirmed a cystic lesion of approximately 10 cm diameter in the area surrounded by the hepatic left lobe, upper pancreas, and lesser curvature of the stomach. Imaging revealed no solid components that were indicative of a tumor within the uniform low-attenuation component of the cyst. Magnetic resonance imaging（MRI） revealed no communication between the cyst and the pancreatic duct. Further, polycystic components were confirmed via an endoscopic ultrasound. Based on these findings, she was diagnosed with cystic lymphangioma derived from the lesser omentum and underwent laparoscopic resection of the lesser omentum tumor. Histopathologic examination revealed cystic lymphangioma. Herein, we report the case with a review of relevant literature. Cystic lymphangiomas derived from the lesser omentum are rare, and in this case, laparoscopic resection was safely performed.