Lymphangiomas
Lymphangioma
circumscriptum
This involves superficial proliferation of capillary sized lymphatic
vessels which comprise fluid-filled vesicles on the surface and larger cisternae
in the subcutaneous tissues and even adjacent muscles. These clear or slightly
haemorrhagic skin vesicles have been considered either as hamartomas or as a
localised deficiency in skin lymphatic drainage. Affected skin and a generous
amount of subcutaneous tissue containing the vessels may be excised if they
cause symptoms, but even with generous margins recurrence is common.
Cystic
hygroma
Cystic hygroma is an abnormal lymph-filled, often multilocular, space
which usually presents in childhood as a soft, brilliantly transluminable
swelling in the base of the neck. It is also found in the head and inguinat
regions as they develop from primitive lymph cisterns. It behaves like a benign
tumour and grows gradually in size, leading to cosmetic problems and compression
of surrounding structures. Recurrence is common after simple aspiration and
injection of sclerosant. Excision is technically challenging due to the large
number of vital structures in the vicinity.
Mesenteric
lymph cysts
These cysts present as well-defined mobile lumps within the abdomen, the
nature of which can be confirmed by either ultrasound or CT. They may be
resected together with the overlying segment of small bowel if they cause
symptoms.