Case contributed by Noura Mahmoud Higo
Diagnosis almost certain


Right check swelling.

Patient Data

Age: 4 years
Gender: Female

A well-defined lobulated outline cystic lesion is seen at the right check, eliciting low T1w and high T2w with marginal and septal enhancement on the post-contrast sequence. The lesion measured about 3.2 x 3x 5 cm along its maximum axial and CC dimensions. The lesion appears superficial to the masseter and buccinator muscle with no intramuscular extension. No enhancing feeding vessels or prominent drainage veins.

Case Discussion

Lymphangiomas are cystic lesions formed by abnormal development of the lymph channels.
Most of them develop in young children, most located in the head and neck region.

On CT, they appear as a homogenous cystic lesion may be inhomogeneous if protein content exists. On MRI, they have a characteristics signal ( some time they have fluid-fluid level if its complicated by hemorrhage):

  • on T1w, they show variable according to the content
  • on T2w, they usually have high signal

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