title: Hemorrhagic giant cystic lymphangioma of the liver in an adult female.
abstract: An 18-year-old woman who presented with epigastric pain was diagnosed with rupture of a hepatic tumor and transported to our hospital. Contrast-enhanced computed tomography revealed a 13-cm, low-density giant mass in the left hepatic lobe and high-density ascites, indicating abdominal bleeding from the liver tumor. The patient underwent emergent celiac angiography, and the left hepatic artery, which was believed to feed the tumor, was embolized. After the patient's condition stabilized, she underwent left hepatic lobectomy. In addition, the enlarged lymph nodes of the hepatoduodenal ligament were dissected. On microscopic examination, immunohistochemical staining revealed that both the liver cyst and the enlarged lymph node were positive for the endothelial marker CD31 and lymphangial marker D2-40. The patient was pathologically diagnosed with cystic lymphangioma of the liver. She has now been followed up for almost 4 years after surgery without any sign of recurrence.
authors.affiliation: Department of Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan yhara02@gmail.com.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Department of Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Shirokawa
authors.affiliation: Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Sadaaki
authors.initials: S
authors.lastname: Shioiri
authors.affiliation: Department of Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yasuno
authors.affiliation: Department of Pathology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Tanaka
references.citation: J Hepatobiliary Pancreat Surg. 2002;9(6):764-8
references.pmid: 12658414
references.citation: Hepatol Int. 2010 Oct 10;4(4):784-7
references.pmid: 21286352
references.citation: J Clin Ultrasound. 1975 Dec;3(4):291-6
references.pmid: 829535
references.citation: Hepatogastroenterology. 2002 Jul-Aug;49(46):1095-7
references.pmid: 12143211
references.citation: HPB Surg. 1994;8(1):33-6
references.pmid: 7993862
references.citation: Pediatr Dev Pathol. 2005 Mar-Apr;8(2):181-9
references.pmid: 15719202