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A case of jejunal hemolymphangioma

Published:November 23, 2022DOI:https://doi.org/10.1016/j.dld.2022.11.007
      A 32-year-old woman presented with half a year history of intermittent anemia. Physical examination revealed anemic appearance, and the laboratory tests showed iron deficiency anemia (hemoglobin was 62 g/L). Esophagogastroduodenoscopy was normal, whereas colonoscopy showed dark-red coffee-like liquids filling the colon and terminal ileum. Computer tomography angiography scan showed localized thickening, swelling, and low-density of the local intestinal wall in the left middle and lower abdomen, without obvious enhancement. A double-balloon enteroscopy revealed a hemispherical nodular mucosal swelling lesion covered with white granular villi at the jejunum segment, and the lesion manifested active bleeding when the endoscopic tube slightly squeezing it (Fig. 1a). Then, exploratory laparotomy was performed, and a 10 cm long lesion was observed in the bowel. Longitudinal anatomical gross specimen, varied sizes and shapes of white nodular eminences crowded and distributed on the lumen surface (Fig. 1b). Pathological diagnosis: hemolymphangioma accompanied by hemorrhage; the lesion was confined to the mucosal and submucosal layer (Fig. 2a,b,c).
      Fig 1
      Fig. 1(a) Double-balloon enteroscopy demonstrated a hemispherical nodular mucosal swelling lesion covered with white granular villi at the jejunum segment.(b) Completly resection of lesion and longitudinal gross specimen dissection, varied sizes and shapes of white nodular eminences crowded and distributed on the lumen surface.
      Fig 2
      Fig. 2Microscopic examination. (a) Low magnifification,H&E stain.The lesion was composed of dilated thin-walled lumen, some of which were dilated and congested, some of which were filled with lymphatic fluid,involving to the submucosa and mucosa of the small bowel.(b) High magnifification,D2–40 stain showed positive lymphatic endothelial cell membrane but negative vascular endothelial cell membrane. (c) High magnifification,CD-31stain showed positive cell membrane of vascular and lymphatic endothelial cells.
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      Reference

        • Yang Shou-Xing
        • Zhou Yu-Hui
        • Zhang Jing
        Haemorrhagic ileal haemolymphangioma: a case report and review of the literature.
        J Int Med Res. 2021; 49300060520986677https://doi.org/10.1177/0300060520986677