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Development of the Lymphatic System01:15

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The development of lymphatic tissues and vessels in embryonic life begins around the fifth week. These structures originate from the mesoderm layer, with lymph sacs emerging from developing veins.
The first lymph sacs to form are the paired jugular lymph sacs located at the junction of the internal jugular and subclavian veins. From these sacs, lymphatic capillary plexuses extend to the thorax, upper limbs, neck, and head, eventually forming lymphatic vessels. Each jugular lymph sac maintains a...
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Axillary lymphatic malformations: Prenatal evaluation and postnatal outcomes.

Aliza Olive1, Julie S Moldenhauer1, Pablo Laje1

  • 1Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Journal of Pediatric Surgery
|May 12, 2015
PubMed
Summary

Prenatal diagnosis of axillary lymphatic malformations is becoming more common. These isolated anomalies typically do not impact fetal health, but recurrences and residual disease are frequent after treatment.

Keywords:
axillary lymphatic malformationprenatal diagnosissclerotherapy

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Area of Science:

  • Fetal Medicine
  • Pediatric Surgery
  • Medical Imaging

Background:

  • Axillary lymphatic malformations (ALMs) are rare developmental anomalies.
  • Improved prenatal imaging technologies enhance early detection.

Purpose of the Study:

  • To describe prenatal findings of fetal axillary lymphatic malformations.
  • To evaluate postnatal outcomes and management of these cases.

Main Methods:

  • Retrospective review of 8 fetuses diagnosed with isolated ALM (2009-2013).
  • Utilized serial ultrasound and ultrafast fetal MRI for evaluation.
  • Postnatal management included surgery, sclerotherapy, or observation.

Main Results:

  • No cases of polyhydramnios or hydrops fetalis observed.
  • One fetus had associated coarctation of the aorta.
  • Treatments showed frequent recurrences (3/8) and residual disease (all patients) at 2.1-year follow-up.

Conclusions:

  • Prenatal diagnosis of ALM is increasing.
  • ALMs are typically isolated and do not compromise fetal health.
  • Recurrences and residual disease are common, necessitating clear communication during prenatal counseling.