Fiberoptic bronchoscopic removal of intratracheal pledgetted repair sutures

The intrascrotal localization of lymphangioma in children is uncommon, especially when the lymphangioma does not depend on testicular structures. We present the case of a 13-year-old male who started with a right intrascrotal mass unconnected with the testicle, clinically and ultrasonically compatible with cystic lymphangioma. The mass was excised because of progressive growth over the previous 5 months, and at surgery a scrotal lymphangioma was disclosed projecting towards the umbilical area through the subcutaneous cell tissue of the anterior abdominal wall. There have been no complications or recurrences to date, 6 months afterwards. Surgical removal is the only efficacious therapeutic approach and is the best way to achieve a definitive diagnosis in these patients.     

Perioperative management for partial resection of a lymphangioma of the tongue

Twelve month old boy had been suffering from a neck lymphangioma. Partial resection was carried out in his newborn period at another hospital, and he was obliged to be tracheostomied because of severe airway obstruction due to postoperative edema. He was scheduled for partial glossectomy since his tongue had increased in mass, which could easily be injured by teeth, and he had difficulties in swallowing recently. His airway was not obstructive even during sleep and preoperative MRI showed adequate space around the larynx. We induced anesthesia by a mask and he was subseqently intubated with a fiberscope via his nose because his huge and less mobile tongue could not allow the insertion of a laryngoscope and this might cause bleeding. We did not extubate the endotracheal tube for fear of airway obstruction attributable to postoperative edema. Marked edema around the neck persisted longer than we expected. We tried to evaluate the degree of diminution of edema with MRI twice to decide when extubation could be attempted. However, examination with MRI could not give us useful informations. Consequently we evaluated the timing of extubation by examining whether he could close his mouth or not, whether his tongue could move freely and the degree of edema. We realized lymphangioma caused marked and extensive edema after the operation and we should keep in mind that lymphangioma of the tongue might cause various anesthetic problems especially on airways.     

Lymphangioma of the thigh following acute trauma

Only 2 cases of lymphangioma of traumatic origin have been previously reported, and in both it was a matter of repeated microtraumas. This is a report of a circumscribed lymphangioma in a 22-year-old man after a severe direct trauma of the thigh. Five months after the trauma a painless, slowly growing mass appeared in this area. Histologically, the removed mass appeared to be a combination of cavernous and cystic lymphangioma. The development of this lesion, which must be considered a hamartoma, may possibly be attributable to a traumatic hematoma and to subsequent reactive fibrosis which may have blocked the lymph drainage possibly from a sequestrated portion of the primitive lymphatic anlage.     

Intrapulmonary cystic lymphangioma: report of a case

We describe herein the case of a 52-year-old man found to have a solitary pulmonary lymphangioma. Computed tomography (CT) scan demonstrated a nodule with homogeneous density and a well-defined border in the lower lobe of the right lung. T2-Weighted magnetic resonance imaging (MRI) revealed a nodule with homogeneously high signal intensity. The tumor was removed by partial resection, and pathologic examination confirmed a diagnosis of primary lymphangioma of the lung.     

Mediastinal cystic lymphangioma: report of two cases

Cystic lymphangioma is an extremely rare mediastinal benign tumor characterized by congenitally enlarged lymphatic vessels. It is often diagnosed incidentally because it is only symptomatic when it grows to be very large. We present two cases of mediastinal cystic lymphangioma and review the literature.     

Improving influenza immunization among healthcare workers

Infected cystic duplication of the duodenum is an unusual lesion. We report a case in which pre-operative MR imaging revealed a huge multicystic mass masquerading as a cystic lymphangioma or mesenteric cyst. The differential diagnosis of this unusual appearance is discussed.     

Cavernous lymphangioma of mediastinum--a case report

A 2-year-old girl with mediastinal cavernous lymphangioma was successfully treated in 1991. She had a cough and an abnormal shadow in the right mediastinum was shown on her chest X-ray. The tumor, which spread from the right upper mediastinum to the pre-aorta, was demonstrated on CT and MRI. On August 8, 1991, the operation was performed through the right thoracotomy. The tumor was located in the right-upper and middle mediastinum and involved N. phrenics and vagus, but didn't invade and was completely resected. It was 4.2 x 3.4 x 3.2 cm in size and the cut surface of the tumor had an appearance consisting of the soft solid tissue, but containing partial cystic spaces. Histological diagnosis was cavernous lymphangioma. The mediastinal cavernous lymphangioma has been reported in only 6 cases in the Japanese medical literature.     

Prenatal diagnosis of an extensive fetal lymphangioma using ultrasonography, magnetic resonance imaging and cytology

An unusual case of fetal lymphangioma diagnosed before delivery is reported in a second trimester pregnant woman. The lymphangioma was suspected at 28 weeks on the basis of the ultrasound appearances and progression of the lesions with advancing gestation. MRI was used to evaluate the extent and the tissue characteristics of the lesions. Cytology of the fluid aspirated from the cystic lesions showed abundant lymphocytes and macrophages, confirming the diagnosis of a lymphangioma. The parents opted for a pregnancy termination because of the rapid growth of the lesions and the poor prognosis. It is suggested that the combination of these tests could enable the early diagnosis of these tumours at a stage when the lesion is relatively limited and accessible to therapy in utero.     

Cystic lymphangioma of the spermatic cord. Report of a new case

We report a new case of spermatic cord lymphangioma in a young patient. It is a rare tumor of the lymphatic system. Only eleven cases have been reported in literature. This lesion tends to recur despite surgical ablation. The pathogenesis of this lesion is still controversial.     

Fetal cystic lymphangioma (cystic hygroma): prepartum ultrasonic findings

The abnormal prepartum ultrasonic scan in a case of fetal cystic lymphangioma is presented. A large intrauterine cystic mass adjacent to a 23-week-old fetus was identified by ultrasound. After delivery, this was proved to be a cystic lymphangioma extending from the fetal neck and supraclavicular region.     

Lymphangioma of bladder

We report the first case of a lymphangioma arising from the wall of the bladder, protruding into the lumen on 1 side and invading the peritoneal cavity on the other side. The presenting sign was painless macroscopic hematuria that had occurred initially 2 months before hospitalization. Treatment consisted of partial cystectomy. A review of the literature failed to reveal a report of an identical case.     

Explaining the unexplained in clinical infectious diseases: looking forward

BACKGROUND: Abdominal lymphangioma is a rare tumour usually classified with mesenteric and retroperitoneal cysts. This experience of abdominal lymphangiomas contrasts the differences between tumours in children and adults. METHODS: Between 1970 and 1996, six patients had surgical resection of an abdominal lymphangioma. RESULTS: There were three children aged 4 years or less and three adults aged 36-76 years. Two children presented with an acute abdomen and one with a rapidly enlarging abdominal girth. Lymphangiomas were located in the mesentery and gastrointestinal tract. In adults, symptoms lasted from months to years and lymphangiomas were found in the pancreas, spleen and retroperitoneum. CONCLUSION: In this series, abdominal lymphangioma presented more acutely in children and usually involved the mesentery, whereas in adults the history was longer and the tumour was found in the retroperitoneum.     

Acute renal failure in idiopathic nephrotic syndrome

The authors report a huge lymphangioma of the tongue in a sixty-seven years old female patient. The remarkable progression in dimensions of this lesion, leading to the inevitable protrusion of the tongue, led to the realization of an extended glossectomy, with a functional objective in mind. This simple procedure showed an excellent five years follow-up results. From this case report, the authors stress up on the etiopathogenic, pathological, clinical as well as therapeutic aspects of lingual lymphangioma.     

Dermatomyositis treated with high-dose intravenous immunoglobulins and associated with panniculitis

A case of a vascular tumor clinically and pathologically consistent with acquired progressive lymphangioma (benign lymphangioendothelioma) in a 48-year-old woman is reported. The lesion appeared in the skin close to a mastectomy scar 3 years after surgery and radiotherapy for invasive ductal carcinoma. On histologic examination, it mimicked an aggressive vascular neoplasm because of its infiltrative pattern. However, follow-up studies confirmed the benign nature of the lesion, clinically and histologically. This case indicates that acquired progressive lymphangioma may follow radiotherapy and must be considered in the differential diagnosis of other vascular proliferations occurring in the skin of the breast, especially of low-grade postradiation angiosarcoma, a recently described neoplastic entity.     

Lymphangioma of the right kidney in an infant boy

A 9-month-old boy with a primary cystic lymphangioma of the right kidney is reported. The clinical and radiological features favored a malignant tumor. Histology revealed the lesion to be a lymphangioma; the diagnosis was confirmed by immunohistochemistry and chemical analysis of the intracystic fluid. Lymphangiomas of the kidney are rare in adults; they are even rarer in infants and children. Nevertheless, renal lymphangiomas should be considered in the differential diagnosis of multicystic, unilateral renal masses, independent of the age of the patient.     

A case of acute hemorrhagic gangrenous acalculous cholecystitis with bile peritonitis during anti-coagulant therapy after coronary-artery bypass grafting

A 10-year-old male Domestic Longhair cat with weight loss, enlarged left testicle, icterus and mild liver enlargement showed, at necropsy, two white, raised, firm, circumscribed masses in the liver and striking enlargement of the left testicle. The histological features of the liver masses were consistent with lymphangioma. Severe, diffuse, coalescing to multifocal, subacute, necrotizing orchitis of the left testicle also was diagnosed. A literature review and examination of the epidemiology of lymphangioma in small domestic animals demonstrated the rarity of this tumour in cats.     

Cystic lymphangioma of the tunica vaginalis testis. A case report

A 42-year-old man who complained progressive enlargement of an intrascrotal mass visited to our hospital. Preoperative sonography revealed multiple cystic masses adjacent to the left testis. Total surgical excision was performed. The cystic masses were arising from tunica vaginalis testis. Histopathologically, a cystic lymphangioma was diagnosed because of the morphological features and the immunohistochemical stainings of CD34 and Factor VIII related antigen which were observed positive reactions in endothelial cells of the cysts.     

Causes and prevention of sudden arrest of circulation in surgical treatment of rheumatic mitral defect

Lymphangiomas are benign tumors, their growth are slow, customarily without symptoms, their location more frequent are in head or neck and they're diagnosed before the two first life years frequently. Their etiology continues uncertain, being accepted the congenital origin. We report on three cases of abdominal lymphangioma beginning as an acute abdomen. The importance of these cases is based mainly in the low frequency of presentation of these tumors in this location (2-5% of the lymphangiomas) and in their initial symptomatology.