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{{Lymphangioma}}
{{CMG}} {{shyam}} {{AE}} {{Badria}} {{HL}}
== Overview ==
== Overview ==
[[Lymphangioma]] is generally diagnosed with non invasive techniques, primarily [[ultrasound]] and [[MRI]]. However, [[X-ray]] often mark the presence of [[cystic]] mass, but then is confirmed with [[ultrasound]] and [[MRI]]. In addition to that [[micropathology]] is confirmed with [[biopsy]] and [[histopathology]].


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
=== Study of choice: ===
* MRI is the gold standard test for the diagnosis of lymphangioma.<ref name="pmid11801972">{{cite journal |vauthors=Kennedy TL, Whitaker M, Pellitteri P, Wood WE |title=Cystic hygroma/lymphangioma: a rational approach to management |journal=Laryngoscope |volume=111 |issue=11 Pt 1 |pages=1929–37 |date=November 2001 |pmid=11801972 |doi=10.1097/00005537-200111000-00011 |url=}}</ref>
* MRI can mar the degree of involvement and extent of lesion.
* MRI can prevent extensive, incomplete surgical resection, because poorly removed lesion can lead to recurrence.


=== Biopsy: ===
=== Biopsy: ===
Biopsy is used to analyze the structure of tissue. It shows<ref name="pmid15402902">{{cite journal |vauthors=WARD GE, HENDRICK JW, CHAMBERS RG |title=Cystic hygroma of the neck |journal=West J Surg Obstet Gynecol |volume=58 |issue=2 |pages=41–7, illust |date=February 1950 |pmid=15402902 |doi= |url=}}</ref><ref name="Turki2017">{{cite journal|last1=Turki|first1=Ali|title=Abdominal Cystic Lymphangioma in Adults: Diagnostic Difficulties and Surgical Outcome|journal=Journal of Universal Surgery|volume=04|issue=05|year=2017|issn=22546758|doi=10.21767/2254-6758.100066}}</ref>
[[Biopsy]] is used to analyze the structure of tissue.
 
*Dilated lymph channels ultimately causes the papillary dermis to expand.
*THese channels extend to subcutis. 
*Deeper vessels have larger lumen and muscular coat.
*The lumen has lymphatic fluid, but it often contains red blood cells, lymphocytes, macrophages, and neutrophils.
*These channels re lined by endothelial cells.
*Numerous lymphoid cells are also seen.  


It shows:<ref name="pmid21938186" />
*Dilated [[lymph]] channels ultimately causes the [[papillary]] [[dermis]] to expand.
*These channels extend to [[subcutis]]. 
*Deeper vessels have larger [[lumen]] and [[muscular]] coat.
*The lumen has lymphatic fluid, but it often contains [[red blood cells]], [[Lymphocyte|lymphocytes]], [[macrophage]]<nowiki/>s, and [[neutrophils]].
*These channels are lined by [[endothelial cells]].
*Numerous [[Lymphoid cell|lymphoid cells]] are also seen.
=== Histochemical staining: ===
=== Histochemical staining: ===
* Histochemical staining is recommended to document lymphangioma.<ref name="PaalThompson1998">{{cite journal|last1=Paal|first1=Edina|last2=Thompson|first2=Lester D.|last3=Heffess|first3=Clara S.|title=A clinicopathologic and immunohistochemical study of ten pancreatic lymphangiomas and a review of the literature|journal=Cancer|volume=82|issue=11|year=1998|pages=2150–2158|issn=0008-543X|doi=10.1002/(SICI)1097-0142(19980601)82:11<2150::AID-CNCR9>3.0.CO;2-Z}}</ref>
* Histochemical staining is recommended to document [[lymphangioma]].<ref name="SauterFoedinger2016">{{cite journal|last1=Sauter|first1=Birthe|last2=Foedinger|first2=Dagmar|last3=Sterniczky|first3=Barbara|last4=Wolff|first4=Klaus|last5=Rappersberger|first5=Klemens|title=Immunoelectron Microscopic Characterization of Human Dermal Lymphatic Microvascular Endothelial Cells: Differential Expression of CD31, CD34, and Type IV Collagen with Lymphatic Endothelial Cells vs Blood Capillary Endothelial Cells in Normal Human Skin, Lymphangioma, and Hemangioma In Situ|journal=Journal of Histochemistry & Cytochemistry|volume=46|issue=2|year=2016|pages=165–176|issn=0022-1554|doi=10.1177/002215549804600205}}</ref><ref name="pmid21938186">{{cite journal |vauthors=Shahi M, Bagga PK, Mahajan NC |title=Cervical cystic lymphangioma in an adult, diagnosed on FNAC |journal=J Cytol |volume=26 |issue=4 |pages=164–5 |date=October 2009 |pmid=21938186 |pmc=3168007 |doi=10.4103/0970-9371.62191 |url=}}</ref>


=== Other Tests: ===
=== MRI: ===
In addition to above, various investigations must be performed in the following order:<ref name="pmid24691940">{{cite journal |vauthors=Park SH, Moon SK, Sung JY |title=Sonographic findings in a case of scrotal lymphangioma |journal=J Clin Ultrasound |volume=42 |issue=4 |pages=234–6 |date=May 2014 |pmid=24691940 |doi=10.1002/jcu.22095 |url=}}</ref><ref name="PaalThompson1998">{{cite journal|last1=Paal|first1=Edina|last2=Thompson|first2=Lester D.|last3=Heffess|first3=Clara S.|title=A clinicopathologic and immunohistochemical study of ten pancreatic lymphangiomas and a review of the literature|journal=Cancer|volume=82|issue=11|year=1998|pages=2150–2158|issn=0008-543X|doi=10.1002/(SICI)1097-0142(19980601)82:11<2150::AID-CNCR9>3.0.CO;2-Z}}</ref><ref name="pmid12063422">{{cite journal |vauthors=Matter D, Grosshans E, Muller J, Furderer C, Mathelin C, Warter S, Bellocq JP, Maillot C |title=[Sonographic imaging of lymphatic vessels compared to other methods] |language=French |journal=J Radiol |volume=83 |issue=5 |pages=599–609 |date=May 2002 |pmid=12063422 |doi= |url=}}</ref>
* MRI is primarily used for the diagnosis of lymphangioma.
* Plain radiograph
* MRI can determine the degree of involvement and extent of lesion.  
* Ultrasound
* MRI can prevent extensive, incomplete surgical resection, because poorly removed lesion can lead to recurrence.
* CT scan


== References ==
== References ==
{reflist|2}
 
<references />
{{reflist|2}}

Latest revision as of 04:19, 10 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2] Associate Editor(s)-in-Chief: Badria Munir M.B.B.S.[3] Haytham Allaham, M.D. [4]

Overview

Lymphangioma is generally diagnosed with non invasive techniques, primarily ultrasound and MRI. However, X-ray often mark the presence of cystic mass, but then is confirmed with ultrasound and MRI. In addition to that micropathology is confirmed with biopsy and histopathology.

Diagnostic Study of Choice

Biopsy:

Biopsy is used to analyze the structure of tissue.

It shows:[1]

Histochemical staining:

MRI:

  • MRI is primarily used for the diagnosis of lymphangioma.
  • MRI can determine the degree of involvement and extent of lesion.
  • MRI can prevent extensive, incomplete surgical resection, because poorly removed lesion can lead to recurrence.

References

  1. 1.0 1.1 Shahi M, Bagga PK, Mahajan NC (October 2009). "Cervical cystic lymphangioma in an adult, diagnosed on FNAC". J Cytol. 26 (4): 164–5. doi:10.4103/0970-9371.62191. PMC 3168007. PMID 21938186.
  2. Sauter, Birthe; Foedinger, Dagmar; Sterniczky, Barbara; Wolff, Klaus; Rappersberger, Klemens (2016). "Immunoelectron Microscopic Characterization of Human Dermal Lymphatic Microvascular Endothelial Cells: Differential Expression of CD31, CD34, and Type IV Collagen with Lymphatic Endothelial Cells vs Blood Capillary Endothelial Cells in Normal Human Skin, Lymphangioma, and Hemangioma In Situ". Journal of Histochemistry & Cytochemistry. 46 (2): 165–176. doi:10.1177/002215549804600205. ISSN 0022-1554.