Lymphangiomas and Lymphedema
Depending on the stage of your lymphedema, there will be other changes that occur in the skin of the affected limb. Not only do these complications involve lymphangiomas, but include changes in skin texture, areas of discoloration, possible growths such as skin tags, dermatofibromas, warts, and even cysts.
Furthermore, lymphangiomas can be associated with other syndromes that include lymphedema, these are:
Lymphangiomas, also known as lymphatic malformations, are abnormal, localized or generalized growths consisting of newly formed, enlarged (dilated) lymphatic vessels. Maybe expressed in lymphedema as blisters containing lymph.
The most common complication is incomplete resection and recurrence. A recurrence rate as high as 50% has been reported. Cranial nerve injury exceeds the rate of 20%; the facial nerve is the most common neural deficit reported.
Additional complications include ocular motility problems, difficulty swallowing, aspiration, lingual and hypoglossal nerve injury, spinal accessory nerve loss, brachial plexus, and phrenic nerve injury. Secondary infection, cosmetic deficits, thrombocytopenia, and secondary airway obstruction have also been recorded.(2)
Dental caries are proportionately prevalent in these patients with oral lymphangiomas and are most likely a result of patient's and dentist's difficulties in maintaining adequate oral hygiene. Dysmorphogenesis of the maxillofacial skeleton is frequently observed in association with oral and cervicofacial malformations. Speech pathologies are common. Feeding difficulties are common in neonates. Alternate enteral feeding routes, including a gastrostomy, are often necessary. Repeated paroxysms of bleeding may occur secondary to trauma. Complications can result from surgical treatment. Complication rates of surgical debulking are typically 20-30%. Complications include airway obstruction, seromas and hematomas, infections, and cranial nerve palsies. Reported surgical mortality rates are 2.5-11.4%. (3)
Generally, lymphangiomas are diagnosed by simple clinical appearance. However, imaging techniques also play an important role in the diagnoses, evaluation and treatment process.
The radiology studies used are ultrasonography, MRI (magnetic resonance imaging) and CT or CAT Scans. At times, artiography may be used for cervicofacial lymphaomas. Lymphoscintigraphy is not used in lymphangiomas.
Research Abstracts and Articles:
Nonsurgical therapies for lymphangiomas: A systematic review.
Otolaryngol Head Neck Surg. 2008 Apr
Department of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC.
OBJECTIVE: Systematically review the published literature regarding the efficacy of nonsurgical therapies in the treatment of head and neck (H&N) lymphatic malformations (LM) in children.
DATA SOURCE: MEDLINE.
REVIEW METHODS: MEDLINE was searched for literature relating to nonsurgical treatments for H&N LM.
RESULTS: The initial search returned 1876 articles, with 22 meeting criteria. The majority (20) were case series. All therapies were percutaneous, with OK-432 or bleomycin sclerotherapy being most common. Random-effects modeling revealed 43% (CI = 28.9%-57%) of patients undergoing OK-432 for LM achieved a complete/excellent response, 23.5% (CI = 5.8%-41.3%) achieved a good response, 16.9% (CI = 10.3%-23.4%) achieved a fair/poor response, and 15.4% (CI = 8.6%-22.2%) observed no response. In the bleomycin group, the results were: 35.2% (CI = 15.7%-54.6%) excellent, 37.1% (CI = 22%-52.3%) good, 18.4% (CI = 2.7%-34.2%) fair/poor, and 11.6% (CI = 3.5%-19.6%) no response. Seven major complications were noted out of the 289 patients in the series, including two mortalities.
CONCLUSIONS: The literature indicates that sclerotherapy for H&N LM achieves excellent/good clinical response in a majority of patients, with few complications, and anecdotally does not complicate future surgery.
Mediastinal cavernous lymphangioma in an adult.
Gen Thorac Cardiovasc Surg. 2008 Feb
Department of Surgery, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Shiga 520-2192, Japan. email@example.com
Cavernous lymphangioma is a rare mediastinal benign tumor. A 43-year-old woman presented with cough and dyspnea for 1 month. Computed tomography of the chest showed a 3-cm well-circumscribed cystic mass in the posterior mediastinum. At thoracotomy, a cystic tumor in the mediastinum that was adherent to the descending aorta and esophagus was removed completely. The tumor, the cystic space of which was filled with lymph fluid, was diagnosed as cavernous lymphangioma based on pathological findings. Mediastinal lymphangiomas may insinuate into surrounding organs. As incomplete resection can result in recurrence, complete tumor removal should be performed based on accurate preoperative evaluation.
Laser excision of multiple esophageal lymphangiomas: A case report and review of the literature.
Auris Nasus Larynx. 2008 Jun
Yale University School of Medicine Division of Otolaryngology, Head & Neck Surgery, New Haven, CT, USA.
Lymphangiomas of the gastrointestinal tract are rare and benign submucosal tumors. We present the first case of multiple lymphangiomas in the cervical esophagus and only the 15th case of an esophageal lymphangioma. A 63-year-old male presented to our clinic with two years of dysphagia and an esophageal mass noted on MRI. A barium swallow confirmed a polypoid mass of the upper esophagus with operative findings of two smooth pedunculated lymphangiomas occupying the entire lumen of the esophagus. Previous reports have documented successful surgical intervention through open or endoscopic techniques, whereas the favorable location of the tumors in this case allowed for the first successful excision utilizing a CO(2) laser. We demonstrate here that esophageal laser surgery can provide an accurate, complete, and minimally invasive excision technique for lymphangiomas of the upper digestive tract with minimal morbidity for the patient. A complete review of all published cases is presented, with a focus on the clinical presentation and surgical treatment of this disease
A case of cardiac lymphangioma presenting as a cystic mass in the right atrium.
Yonsei Med J. 2007 Dec 31
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea, 290-3 Jeonha-dong, Dong-gu, Ulsan 682-714, Korea.
A 44-year-old woman underwent surgery for an asymptomatic primary tumor of the heart located in the right atrium. The tumor was detected incidentally during follow-up computed tomography for a resected breast cancer. The mass, lying along the lower portion of the right atrial septum, was homogenous and cystic in nature, as detected by transthoracic and transesophageal echocardiography. Complete resection was performed via a median sternotomy under cardiopulmonary bypass. The postoperative course was uneventful. However, the histological result was surprising: the mass was a cardiac lymphangioma.
Cystic lymphangioma of the gallbladder: report of a case.
Surg Today. 2008
Department of Surgery II, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Abdominal lymphangioma is usually diagnosed within the first 2 years of life and is extremely rare in adults. The most common location of abdominal lymphangioma is the mesentery, but there are sporadic reports of its development in the gallbladder. A 66-year-old woman was found to have a cystic lesion near the gallbladder. Preoperative studies, including endoscopic ultrasonography, computed tomography, and magnetic resonance imaging, showed a tumor with multilocular cystic structure, originating in the gallbladder fossa. The patient underwent exploratory laparotomy, and the mass was resected en bloc with the gallbladder, as there was no evidence of malignancy on intraoperative ultrasonography. Macroscopically, the tumor was a multilocular cystic mass, 6 x 3 x 2 cm in size, with a rough, sponge-like appearance. Histologically, the cystic tumor was diagnosed as a lymphangioma, originating in the gallbladder. To our knowledge, only three other cases of a cystic lymphangioma originating in the gallbladder have been reported in the medical literature of the world.
Cervicofacial Lymphangiomas (2)
Oral Lymphangiomas (3)
What is Lymphangiomas?
Lymphangiomas of the Head and Neck
Bilateral symmetrical lymphangiomas of the gingiva: case report
Sclerosing treatment of lymphangiomas with OK-432
Cavernous, arteriovenous, and mixed hemangioma-lymphangioma of the rectosigmoid: rare causes of rectal bleeding-case series and review of the literature.
Acquired lymphangioma circumscriptum of the vulva.
Surgical management of primary vulvar lymphangioma circumscriptum and postradiation: case series and review of literature.
Ultrasound biomicroscopy of eyelid lymphangioma in a child.
Establishment of lymphangioma model and a study on the promoting effect of murine melanoma cell B16-F1 on the lymphangiogenesis in vitro.
Gastrointestinal tract lymphangiomas: findings at CT and endoscopic imaging with histopathologic correlation.
Lymphangioma scroti. Lymphangioma of the Tongue
Lymphangioma of the Tongue, A Rare Entity Giant Lymphagioma of the Tongue
Small Bowel Lymphangoima
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Diagnostic Codes and External Resources:
||Lymphangioma circumscriptum cutis|
Hemangioma and lymphangioma any site
228.0 is a non-specific code that cannot be used to specify a diagnosis
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