Lymphangioma

ICD-O:9170/0

Lymphangioma is a benign, cavernous or cystic vascular lesion composed of dilated lymphatic channels. The head and neck region is the most common site of involvement. Many lesions are present at birth or develop within the first few years of life. There appears to be no sex predilection. They usually form painless swellings that are frequently superficial, but some extend deeply into the surrounding tissues and are ill-defined.

Oral lesions are seen most commonly in the tongue and lips where they may cause macroglossia and mac-rocheilia respectively. Involvement of underlying bone in oral lesions is uncommon [133]. Mucosal lymphan-giomas usually have a pale, translucent surface, which is nodular or bossellated. It is common for black areas to appear in the lesion due to focal areas of haemorrhage.

In the neck, the lesions tend to be larger and show more extensive cystic dilatation. These lymphangiomas are then frequently called cystic lymphangiomas or cystic hygromas [91]. Some are associated with Turner syndrome (Monosomy X) [28]. The most common locations for cystic hygroma are the posterior triangle, subman-dibular region and floor of the mouth. It can extend upwards to involve the cheek and parotid gland, forwards into the anterior triangle or downwards into the mediastinum. Some cystic hygromas are severely disfiguring and they can compromise swallowing or breathing. The classification and microscopic aspects of oral lymphan-giomas are discussed in Chap. 9.

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