Lymphangioma diagnostic study of choice: Difference between revisions

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=== 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 is the gold standard test for the diagnosis of lymphangioma.
* MRI can mar the degree of involvement and extent of lesion.  
* 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.  
* 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. It shows


*Dilated lymph channels ultimately causes the papillary dermis to expand.
*Dilated lymph channels ultimately causes the papillary dermis to expand.
*THese channels extend to subcutis.   
*These channels extend to subcutis.   
*Deeper vessels have larger lumen and muscular coat.
*Deeper vessels have larger lumen and muscular coat.
*The lumen has lymphatic fluid, but it often contains red blood cells, lymphocytes, macrophages, and neutrophils.
*The lumen has lymphatic fluid, but it often contains red blood cells, lymphocytes, macrophages, and neutrophils.
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=== 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.


=== Other Tests: ===
=== Other Tests: ===
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>
In addition to above, various investigations must be performed in the following order:<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>
* Plain radiograph  
* Plain radiograph  
* Ultrasound  
* Ultrasound  

Revision as of 20:28, 13 October 2018

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

Study of choice:

  • MRI is the gold standard test for the diagnosis of lymphangioma.
  • 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 is used to analyze the structure of tissue. It shows

  • 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.

Histochemical staining:

  • Histochemical staining is recommended to document lymphangioma.

Other Tests:

In addition to above, various investigations must be performed in the following order:[1]

  • Plain radiograph
  • Ultrasound
  • CT scan

References

{reflist|2}

  1. Paal, Edina; Thompson, Lester D.; Heffess, Clara S. (1998). "A clinicopathologic and immunohistochemical study of ten pancreatic lymphangiomas and a review of the literature". Cancer. 82 (11): 2150–2158. doi:10.1002/(SICI)1097-0142(19980601)82:11<2150::AID-CNCR9>3.0.CO;2-Z. ISSN 0008-543X.