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Submandibular lymphatic malformation

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Left submandibular swelling

Patient Data

Age: 20 years
Gender: Female

Left submandibular lesion with homogeneous texture and lobulated outer borders, deep to platysma, anterior to the left submandibular gland and extending upwards medial to the left mandibular body and pterygoid muscles. 

Left submandibular lesion with homogeneous texture and lobulated outer borders. It lies deep to platysma, anterior to the left submandibular gland and extending upwards medial to the left mandibular body and pterygoid muscles. 

It shows homogeneous hyperintense signal on T1 and T2, with an accentuated signal on fat-suppressed sequences. It shows no diffusion restriction or postcontrast enhancement. Thin irregular internal septations are noted.

Case Discussion

CT and MRI features are suggestive of left submandibular lymphatic malformation. It most commonly occurs in pediatric age group, with marked predilection in the head and neck (95%). They are painless masses that present due to mass effect. High T1 signal may be due to high protein content. 

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