Lymphangioma of the Colon: A Curious Endoscopic Finding

Abstract

40-year-old manwithapositiveimmunologicfecaltest and a history of hematochezia for a fewmonths underwent total colonoscopy previously atanother clinic. A rectal tumor was detected during thecolonoscopy,forwhichhewasreferredtoourhospital.Hehad no other gastrointestinal symptoms except hema-tochezia and no remarkable medical history, and he wasnot taking any medication. He was a nonsmoker andconsumed6unitsofalcoholper week(1unitof alcohol ¼500mLofbeer).Furthermore,hehadnofamilyhistoryofcolorectal cancer. Hematologic examinations revealed noabnormality.Totalcolonoscopyperformedatourhospitalrevealed multiple curious findings in the cecum andascending colon (Figure A). The tumor was diagnosed asearly rectal cancer, for which the patient underwentendoscopic mucosal resection.Biopsyspecimenstakenfromthececumandascendingcolon revealed the diagnosis of lymphangioma (Figures Band C). Proliferation of ecstatic lymphatic vessels with athin wall structure was observed in the lamina propria.Crypts in the lamina propria were decreased because ofincreased lymphatic vessels. Meanwhile, the rectal lesionwas diagnosed as intramucosal adenocarcinoma withadenomatous components. Surveillance colonoscopicexamination was performed after 6 months. Lym-phangiomas in the cecum and the ascending colon haddisappeared with minute scars.Lymphangioma is a misnomer and reactive proli-feration of gastrointestinal tract. This condition of colonis a rare entity and usually presents as a sessile or semi-pedunculated mass with smooth surface mucosa for uni-locular or multilocular lymphatic cystic dilatation.