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Lymphatic Malformation (Lymphangioma) - Radiology

last modified on: Sun, 09/01/2024 - 20:34

see also: Sclerotherapy with Ultrasound Guidance for Lymphangioma with Doxycycline

  • Also known as lymphangioma
  • Congenital developmental anomalies of the lymphatic system forming micro- or macrocytstic lesions (Wiegand et al. 2022; Bertino et al. 2021)
  • Associated with Proteus and CLOVES syndrome (Wiegand et al. 2022)
  • Most commonly present in head and neck region but may be in other lymphatic-rich areas as well (Wiegand et al. 2022)
  • Usually presents within first two years of life but may have a delayed presentation in adulthood (Wiegand et al. 2022)
    • Larger lesions may be seen on prenatal imaging (Bertino et al. 2021)
  • Symptoms include minimal swelling to possible airway obstruction, impaired oral feeding, macroglossia, loss of vision, and pain (Wiegand et al. 2022)
  • Acute enlargement may occur with infection, trauma, or hemorrhage; otherwise, it generally grows proportionally as the patient grows (Wiegand et al. 2022)
  • On CT: Fluid densities, poorly-circumscibed with or without fluid levels, no enhancement with contrast
  • On MR: Hypointense on T1 unless hemorrhage or abscess present; hyperintense on T2; post-contrast T1 is non-enhancing unless infected

References

Wiegand S, Dietz A, Wichmann G. Efficacy of sirolimus in children with lymphatic malformations of the head and neck. Eur Arch Otorhinolaryngol. 2022 Aug;279(8):3801-3810. doi: 10.1007/s00405-022-07378-8. Epub 2022 May 8. PMID: 35526176; PMCID: PMC9249683.

Bertino F, Trofimova AV, Gilyard SN, Hawkins CM. Vascular anomalies of the head and neck: diagnosis and treatment. Pediatr Radiol. 2021 Jun;51(7):1162-1184. doi: 10.1007/s00247-021-04968-2. Epub 2021 Apr 16. PMID: 33860862.