LYMPHANGIOMA - Lymphatic Malformation
This page has been updated. For current information, please see the following pages:
Lymphangiomas
http://www.lymphedemapeople.com/thesite/lymphedema_lymphangiomas.htm
Cystic
Hygroma
http://www.lymphedemapeople.com/thesite/lymphedema_cystic_hygroma.htm
Lymphatic
Malformations
-------------------------------------
LYMPHANGIOMA
- Lymphatic Malformation
Related
Terms:
Cutaneous lymphangioma, lymphangioma
circumscriptum,
cavernous lymphangioma, cystic hygroma, abnormal lymph vessel, lymph
vessel (1)
Classification:
Lymphatic Malformation
Clinical:
A lymphangioma is a benign tumor composed of newly formed
lymph-containing
vascular channels and spaces. They involve the skin and subcutaneous
tissues.
There are
three main types of lymphagiomas:
Lymphangioma
circumscriptum
- Also
referred to as cutaneous this is a
"kind" of birthmark generally occurring in clusters. They resemble
small blisters and range in color from pink to dark red. They are
benign and
usually require no medical treatment. For cosmetic reasons, some
patients may
choose to have them surgically removed. Lymphangiomas Simplex is often
included
in this type.
Cavernous
lymphangioma
- This is
an uncommon form generally arising
during infancy. These are deep seated underneath the dermis and the
external
skin is not involved. Because they are deep seated, they form a bulging
mass,
painless mass.
Cystic
Hygroma
- These
are soft lymph filled masses within a thin-walled
"sac" generally appearing on the neck (75%), axilla (20%), or trunk or
extremity (5%). They usually present a swollen bulges underneath the
skin. While
they generally present at birth, children up to three years old may
experience
them. There is also disagreement on whether this type is distinctly
different enough from cavernous lymphangioma to be classified
separately.
Diagnosis:
Confirmed through use of x-ray, ultra-sound, MRI, CT scan for cavernous
and
cystic hygromas. Lymphangioma circumscriptum may be diagnoses by
observation and
external evaluation.
Treatment:
There is no recognized or effective non-surgical treatment for the
condition.
Antibiotics may be prescribed to cellulitis infections.
The accepted therapy is total surgical removal, however incidence of
recurrence is high. However, if there has been infiltration of
surrounding
tissues treatments may include sclerosings agents, steroids,
chemotherapy or
even radiation. Also, even with removal, there is a high incidence of
reoccurrence.
Complications:
Cellulitis is the most common and most serious complication of all
hygromas.
With cavernous and cystic hygromas another life threatening
complication may be
the obstruction of breathing passages.
Definition:
Old term for a mass of anomalous lymphatic vessels or channels that
vary in
size, are usually greatly dilated, and are lined with normal
endothelial cells;
lymphoid tissue is usually present in the peripheral portions of the
lesions,
which are present at birth, or shortly thereafter, and probably
represent
maldevelopment of lymphatic vessels (rather than true neoplasms); they
occur
most frequently in the neck and axilla, but may also develop in the
arm,
mesentery, retroperitoneum, and other sites. Etymology: lymphangio- +
G. [-oma,]
tumor (Stedman's Medical Dictionary)
-------------------------------------
These
lymph channel or cystic lymph spaces lined by endothelium are probably
the result of abnormalities in lymphangiogenesis (lymphatic
development). Lymphangiomata or lymphatic endothelial “cysts” usually
grow slowly and may gradually compress surrounding structures, but they
do not undergo malignant changes.
Localization
Lymphangiomata
can arise almost anywhere in the skin, subcutaneous tissue,
intermuscular septa and mucous membranes. The most common sites are the
head and neck (including the tongue), the proximal extremities, trunk
and buttocks. Rarely they can be found in the abdominal viscera (liver,
spleen, intestines, heart, pancreas).
Clinical
manifestations:
There
are four classical types of lymphangioma:
1-
Lymphangioma simplex
These
are single, well-circumscribed, usually smooth, subcutaneous tumors.
2- Lymphangioma circumscriptum
A
very common form of cutaneous lymphangioma consisting of multiple
clusters of clear, pink or red vesicles. Pink or red appearance
indicates the presence of blood mixed in with the lymph; in this case,
mixed vascular malformations are present.
3-
Cavernous lymphangioma
A
large soft tissue tumor composed of cavernous lymphatic spaces. This
condition is rare.
4- Cystic lymphangioma or cystic hygroma
These
benign lymphatic tumors are unilocular or multilocular masses composed
of a collection of thin-walled vesicles resembling a bunch of grapes,
filled with clear or yellowish lymph fluid.
These
cysts are usually soft, translucent and painless.
They
are most commonly located in the neck (hygroma colli), head, intraoral
(tongue, floor of the mouth, salivary glands), mediastinum, axilla,
groin, and popliteal fossa.
Complications
Lymphangiomata
may swell. On rare occasion they become infected or hemorrhage. Their
extension may lead to respiratory or digestive problems, chylothorax or
chylopericardium (accumulation of chyle or lymph in the thorax or
pericardium, respectively).
Treatment
These
conditions usually require surgery, laser therapy or sclerotherapy.
Some
lesions (especially lymphangiomata circumscripta and cavernous
lymphangiomata) have high recurrence rates after excision.
Information about Dr. Chikly's book:
In his definitive text, "Silent Waves: Theory and Practice of Lymph
Drainage
Therapy," Dr. Chikly addresses the applications for lymphedema, chronic
pain
and inflammation. "Silent Waves" is carried by Stanford University
Medical
Library and is the first comprehensive book on the lymphatic system and
lymphedema in North America. (ISBN: 0-9700530-5-3, Hardcover).
A book review is at:
http://www.upledger.com/therapies/waveldt.htm
Ordering is available from:
http://iahe.com/controller/IaheProductDisplay?productCode=SW
----------------------------------------
For
further information:
----------------------------------------
Lymphangioma
eMedicine
Author: Geover Fernandez, MD, Staff Physician, Department of
Dermatology, UMDNJ-New
Jersey Medical School
http://www.emedicine.com/derm/topic866.htm
...........
Cystic Hygroma Support Group
http://www.cafamily.org.uk/Direct/c95.html
...........
CysticHygroma.co.UK
http://www.cystichygroma.co.uk/
...........
Cystic Hygroma
AllRef Health.com
http://health.allrefer.com/health/cystic-hygroma-info.html
...........
Cystic Hygroma
eCureMe.com
http://www.ecureme.com/emyhealth/Pediatrics/Cystic_Hygroma
===========================
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Lymphedema People / Advocates for Lymphedema
===========================
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===========================
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Children
with Lymphedema
The time has come for families, parents, caregivers to have a support
group of
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......................
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No matter how you spell it, this is another very little understood and
totally
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......................
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......................
All
About Lymphangiectasia
Support group for parents, patients, children who suffer from all forms
of
lymphangiectasia. This condition is caused by dilation of the
lymphatics. It can
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http://health.groups.yahoo.com/group/allaboutlymphangiectasia/
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......................
Lymphatic
Disorders Support Group @ Yahoo Groups
While we have a number of support groups for lymphedema... there is
nothing out
there for other lymphatic disorders. Because we have one of the most
comprehensive information sites on all lymphatic disorders, I thought
perhaps,
it is time that one be offered.
DISCRIPTION
Information and support for rare and unusual disorders affecting the
lymph
system. Includes lymphangiomas, lymphatic malformations,
telangiectasia,
hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of
information
available through sister site Lymphedema People.
http://health.groups.yahoo.com/group/lymphaticdisorders/
Subscribe: lymphaticdisorders-subscribe@yahoogroups.com
......................
All
About Lymphedema
For our Google fans, we have just created this online support group in
Google
Groups:
Homepage: http://groups-beta.google.com/group/All-About-Lymphedema
Group email: All-About-Lymphedema@googlegroups.com
......................
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Groups, come and join us there.
===========================
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