Adrenal Lymphangiomatous CYST with papillary and pseudopapillary endothelial proliferation and sinaptophysin positivity: A Case Report

Year 2025, Volume: 39 Issue: 1, 61 - 65, 12.03.2025

Ali Mızrak

Abstract

Benign adrenal cysts are rare lesions. Although they can cause some clinical symptoms such as abdominal distension and pain, they are mostly encountered incidentally. The most common are pseudocysts, endothelial, epithelial, and parasitic cysts. Endothelial cysts may be of vascular or lymphatic origin. In this case report, a unilocular lymphangiamotous adrenal cyst showing marked papillary and micropapillary proliferation and synaptophysin positivity is discussed in the light of current literature.

Keywords

Adrenal cyst, endothelial proliferation, lymphangiomatous cyst, synaptophysin

References

• 1. Solanki S, Badwal S, Nundy S, Mehta NN. Cystic lesions of the adrenal gland. BMJ Case Rep. 2023 May 4;16(5):e254535. doi: 10.1136/bcr-2022-254535. PMID: 37142280; PMCID: PMC10163428.
• 2. Issam R, Amine MM, Meriam T, Ahmed C, Mehdi B, Mourad HS. Lymphangiomatous endothelial cyst of the adrenal gland: A case report. Urol Case Rep. 2021 Sep 18;39:101859. doi: 10.1016/j.eucr.2021.101859. PMID: 34621624; PMCID: PMC8479637.
• 3. Yu N, Du J, Zheng G, Zheng Y. Giant adrenal cyst: A case report. Cureus. 2023 Apr 3;15(4):e37086. doi: 10.7759/cureus.37086. PMID: 37153235; PMCID: PMC10159221.
• 4. Wu MJ, Shih MH, Chen CL, Meng E. A 15-year change of an adrenal endothelial cyst. Am J Case Rep. 2022 Apr 22;23:e935053. doi: 10.12659/AJCR.935053. PMID: 35450977; PMCID: PMC9040078.
• 5. Zlatarov A, Drenakova P, Mihaylov S, Zgurova N, Petkova L, Ivanov KD. Malignant psammomatous melanotic schwannoma mimicking adrenal cyst: case report. Ann Pediatr Surg. 2022;18(1):51. doi: 10.1186/s43159-022-00189-w. Epub 2022 Jul 7. PMID: 35818469; PMCID: PMC9261228.
• 6. Gubbiotti MA, LiVolsi V, Montone K, Baloch Z. A cystematic analysis of the adrenal gland: A compilation of primary cystic lesions from our institution and review of the literature. Am J Clin Pathol. 2022 Apr 1;157(4):531-539. doi: 10.1093/ajcp/aqab156. PMID: 34596217.
• 7. Ellis CL, Banerjee P, Carney E, Sharma R, Netto GJ. Adrenal lymphangioma: clinicopathologic and immunohistochemical characteristics of a rare lesion. Hum Pathol. 2011 Jul;42(7):1013-8. doi: 10.1016/j.humpath.2010.10.023. Epub 2011 Feb 11. PMID: 21315417.
• 8. Marques-Piubelli ML, Gonzales EWP, Gonçalves VL, Balancin ML, Botelho MLAA, Yamauchi FI, de Mello Ando S, Brondani VB, Chambo JL, Fragoso MCBV, Zerbini MCN. Adrenal cysts of lymphatic origin: A clinical and pathological study of six cases and systematic literature review. Ann Diagn Pathol. 2022 Apr;57:151888. doi: 10.1016/j.anndiagpath.2021.151888. Epub 2022 Jan 4. PMID: 35121238.
• 9. Koperski Ł, Pihowicz P, Anysz-Grodzicka A, Górnicka B. Cystic lymphangiomatous lesions of the adrenal gland: A clinicopathological study of 37 cases including previously unreported cysts with papillary endothelial proliferation. Pathol Res Pract. 2019 Jun;215(6):152385. doi: 10.1016/j.prp.2019.03.014. Epub 2019 Mar 6. PMID: 30862368.
• 10. Zheng W, Fung KM, Cheng L, Osunkoya AO. Benign vascular tumors, cysts, and pseudocysts of the adrenal gland: a contemporary multi-institutional clinicopathological analysis of 55 cases. Hum Pathol. 2018 Dec;82:95-102. doi: 10.1016/j.humpath.2018.07.013. Epub 2018 Jul 21. PMID: 30041023.
• 11. Cheuk W, Shum KS, Ng WK, Chan JKC. Composite Hemangioendothelioma with neuroendocrine marker expression: Report of a "paraganglioma-like" paravertebral case. Int J Surg Pathol. 2020 Oct;28(7):759-763. doi: 10.1177/1066896920924120. Epub 2020 May 18. PMID: 32418470.