Fact-sheet: Cystic lymphangioma of head and neck
Updated on 04/18/2017 at 7:10 AM
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Definition
Cystic lymphangioma is a rare benign vascular-lymphatic dysembryoplastic tumor.
It is a ubiquitous tumor except in the brain, with 80% occurring in the face and neck.
It arises from lymphatic sac remnants, resulting from a failure of fusion between the primitive lymphatic sac and the venous system.
Clinical features
Painless, soft, compressible cervical mass with progressive onset within the first 2 years.
Located in the submandibular region and posterior cervical spaces.
Slow growth.
Possible hemorrhagic or infectious events during its natural history.
Ultrasound
Infiltrating cystic mass, involving several contiguous spaces.
Anechoic, rarely echogenic (chylous content).
Multiloculated, rarely uniloculated.
No peripheral or septal vascularity (in the absence of inflammatory change).
Compressible.
Calcific component possible, soft tissue component rare.
If hemorrhage occurs: fluid-fluid level.
CT
Hypodense, poorly circumscribed mass without enhancement.
Calcifications well demonstrated.
MRI
Reference examination.
Fluid signal: T1 hypointense, T2 hyperintense.
Septa are T1 hypointense, T2 hypointense.
No or minimal wall and septal enhancement
Management
Simple surveillance if asymptomatic.
Percutaneous sclerotherapy.
Surgical resection
Differential diagnosis
In the cervicofacial region:
Teratoma.
Second or third branchial cleft cyst.
Thyroglossal duct cyst, if midline.
Cervical bronchogenic cyst.
Abscess