Lymphangioma

Lymphangiomas are benign lesions of vascular origin that show lymphatic differentiation. It is considered the lymphatic equivalent of a haemangioma of blood vessels. 

This article focuses the general features and head and neck lymphangiomas, as they mostly occur in this region. For a specific discussion in other locations, please refer on the articles:

They can present at any age but most often occur in the paediatric population (~90% on those less than 2 years of age 3). 

Generally, presentation may be with symptoms related to local mass effect and/or haemorrhage.  For example, a lymphangioma within the orbit may present with progressive proptosis with acute deterioration in symptoms, mass effect resulting in compressive optic neuropathy, diplopia/ocular muscle weakness and orbital bruising.

Typically comprised of thin-walled cystic masses and may contain large macroscopic interconnecting cysts: (cystic hygroma or cystic lymphangioma) or microscopic cysts (cavernous lymphangioma). Their wall consists of connective tissue, smooth muscle, fat, blood vessels, nerve, or lymphatic tissue. 

Location

They can occur at almost any location 

Subtypes

There are several recognised subtypes:

Associations
CT

Most lymphangiomas appear homogeneous and cystic on CT, but some appear inhomogeneous because of the presence of proteinaceous, fluid, blood, or fat components within the lesion. It is rare for CT to demonstrate intrinsic septations. There is only minimal or no displacement/compression of adjacent structures.

MRI

Fluid-fluid levels may be seen if complicated by haemorrhage. Signal characteristics include:

  • T1: can be variable especially dependent on protein content
  • T2: usually high signal
  • content pending

Possible imaging differential considerations include:

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Article Information

rID: 1611
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Lymphangiomas
  • Lymphangioma - general
  • Lymphangiomas - general

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