Presentation on theme: "LYMPHANGIOMA OF NECK Dr. C. Anjaneyulu Senior Consultant Dept. of Otorhinolaryngology Global Hospital Hyderabad."— Presentation transcript:
1 LYMPHANGIOMA OF NECKDr. C. Anjaneyulu Senior Consultant Dept. of Otorhinolaryngology Global Hospital Hyderabad
2 Introduction Benign congenital proliferation of lymphatic tissue. 3 groups Lymphangioma simplex2. Cavernous lymphangioma3. Cystic hygromaReported incidence - 4 in 100,000 live births.90% are detected by the end of second yr.Rare in adults.
3 EtiologyCongenital - Blockage or arrest of the primordial lymph channelsAcquired – TraumaInfectionTumor
4 Common site - Cervical region Lymphatic system is more complex and extensive in the cervical region.
5 20 year old femaleComplaint - swelling in right side of neck from 3 years.gradually increasingPast history - Initially patient received ATT for 9 months because physician diagnosed it as TB lymphadenitisExamination - Diffuse, soft,lobulated, irregular, nontender and nonpulsatile swelling extending from mastoid tip and lower border of mandible to the clavicle
6 InvestigationsMRI - Well defined encapsulated, obulated cystic lesion in the anterolateral and posterolateral compartment of neck in subcuticular plane. It is extended into retro pharyngeal space in prevertebral plane.
7 FNAC - LymphangiomaRoutine investigations - Normal
8 Surgery - Transcervical excision under general anaesthesia Tumor was found in subcuticular plane.
9 Multilobulated cystic swelling in carotid triangle and posterior triangle.
10 Tumor removed from retropharyngeal space and between great vessels. Another separate cystic mass removed from supraclavicular fossa.
14 26 year old femaleComplaint - Swelling in right side of neck from 6 yr. gradually increasingExamination - 10 cm and 6 cm diffuse swelling extending from mastoid tip and lower border of mandible to junction of upper two third and lower one third of sternocleidomastoid muscle.Irregular, lobulated, non tender, non pulsatile with ill defined margins.
15 InvestigationsUltrasound - large inhomogenous mass in right upper neck and encircling the internal jugular vein.FNAC - Lymphangioma
16 CECT Scan - Large well defined low density soft tissue mass deep to the sternocleidomastoid muscle on right side, starting just below the right parotid gland and extending up to the root of the neck by the side of right lobe of thyroid gland. Mass separating the IJV from carotid vessels and partly wrapped the IJV.
17 Surgery - Transcervical excision under general anaesthesia Tumor was found in subcuticular plane.Lobulated,soft, cystic mass extended from mastoid tip to middle one third of sternocleidomastoid muscle.Tumor was removed between great vessels.Cranial nervas in the neck were identified and preservedPost operative events - Normal
18 FOLLOW UPAt 18 Months –AsymptomaticNo recurrence of disease
19 DISCUSSION Symptoms Common - Painless swelling Rare - Dysphagia, Dyspnoea, Pain,Sudden increase in size
20 Examination Soft Fluctuant Lobuted Transilluminent Not attached to skin
21 Radiology - Extent of lesion Ultra sound - Multi locular cystic mass containing septa of variable thickness and solid components.CECT Scan - Low density mass with thin capsule.MRI - Hypo intense on T1W1 and Hyper intense on T2W1