And Lymphangioma

Cystic hygroma and lymphangioma represent the two ends of the spectrum of the histopathologic classification of lymphatic lesions [124]. Whether these are true neoplasms or represent malformations or hamartomas is still debated, but this issue is of no clinical consequence. These lymphatic lesions may be divided into three morphologic types: capillary (lymphangioma circumscriptum, ICD-O:9171/0), cavernous (lymphangioma cav-ernosum, ICD-O:9172/0), and cystic (cystic hygroma, ICD-O:9173/0) [34].

Lymphangiomas are relatively rare. Almost all lymphangiomas appear during the first 2 years of life, most commonly in the oral cavity, parotid gland, neck or axilla. Lymphangiomas often lie in the lateral cervical region beneath the platysma, less frequently in the anterior cervical region, and may extend into the mediastinum.

Cervical cystic hygroma (hygroma colli cysticum) is a cystic lymphangioma of the neck. It can be associated with foetal hydrops and Turner's syndrome [27]. This lesion consists microscopically of lymphatic channels of variable size and shape lined with typical endothe-lial cells. Focal infiltrates of lymphocytes in the stroma are common.

The main differential diagnosis of lymphangio-mas of the head and neck is cavernous haemangioma. Lymphangiomas contain proteinaceous fluid and thin valves, and the surrounding tissue is usually infiltrated by lymphocytes, whereas cavernous haemangiomas are filled with red blood cells and lack valve structures.

Treatment of lymphangioma consists of surgery; staged procedures may be required for large lesions. Recurrence rates range from 15 to 80% [38].

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