Lymphangioma diagnostic study of choice

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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.[1]
  • 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[2][3]

  • 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.[4]

Other Tests:

In addition to above, various investigations must be performed in the following order:[5][4][6]

  • Plain radiograph
  • Ultrasound
  • CT scan

References

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  1. Kennedy TL, Whitaker M, Pellitteri P, Wood WE (November 2001). "Cystic hygroma/lymphangioma: a rational approach to management". Laryngoscope. 111 (11 Pt 1): 1929–37. doi:10.1097/00005537-200111000-00011. PMID 11801972.
  2. WARD GE, HENDRICK JW, CHAMBERS RG (February 1950). "Cystic hygroma of the neck". West J Surg Obstet Gynecol. 58 (2): 41–7, illust. PMID 15402902.
  3. Turki, Ali (2017). "Abdominal Cystic Lymphangioma in Adults: Diagnostic Difficulties and Surgical Outcome". Journal of Universal Surgery. 04 (05). doi:10.21767/2254-6758.100066. ISSN 2254-6758.
  4. 4.0 4.1 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.
  5. Park SH, Moon SK, Sung JY (May 2014). "Sonographic findings in a case of scrotal lymphangioma". J Clin Ultrasound. 42 (4): 234–6. doi:10.1002/jcu.22095. PMID 24691940.
  6. Matter D, Grosshans E, Muller J, Furderer C, Mathelin C, Warter S, Bellocq JP, Maillot C (May 2002). "[Sonographic imaging of lymphatic vessels compared to other methods]". J Radiol (in French). 83 (5): 599–609. PMID 12063422.