MRI neck (infrahyoid)
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A multiloculated largely cystic appearing lesion is seen in the right neck, trans-spatial in nature with components in the supraclavicular region and posterior triangle. Overall dimensions are approximately 4.3 x 4.3 x 5.4 cm. Most of the components are simple cystic in nature with thin septation. Smaller multilobulated components are seen more posteriorly with linear internal enhancement of septations-this may represent hemangiomatous/venous element. A further septated component is seen extending posterior to the left carotid space into the prevertebral region and extending into the right superior mediastinum. The trunks and divisions of the right brachial plexus are displaced posteriorly and inferiorly.
Conclusion: Findings compatible with a lymphangioma with possible small venous element posteriorly.
Most lymphangiomas occur in the head and neck.
They are also seen on the liver, spleen, kidneys and retroperitoneum.
They are benign vascular lesions of lymph.
MRI imaging is typical with lesions isointense on T1, high signal on T2, with no contrast enhancement.
Transpatial involvement is common.