Neck vascular lymphatic malformation

Case contributed by Amira Ashraf Gad

Presentation

Left-sided cystic neck swelling. No other associated symptoms.

Patient Data

Age: 10 years
Gender: Male

A large multilocular cystic lesion is seen at the left lateral aspect of the neck, measuring about 10 x 9.4 x 11.3 cm in its maximum AP, TR, and CC diameters respectively. The lesion demonstrates low T1 and high T2 signals with internal septae of low T2 signal. It shows free diffusion. After contrast administration, it shows a faint enhancement of the wall and septae. 

The lesion displaces the left sternomastoid muscle and carotid sheath vessels medially with the latter being patent and signal void. It extends inferiorly to the upper anterior chest wall and axillary region.

Case Discussion

The MRI features of low flow lymphatic malformations, as in this case, exhibit low T1 and high T2 signals with no internal enhancement in contrast images, only faint peripheral +/- septal enhancement could be seen.

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