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Anatomic distribution of cervicofacial lymphatic malformations based on lymph node groups
Phayvanh P Sjogren1, Ryan W Arnold2, Jonathan R Skirko1
1Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
Insights
This study identified common locations and radiographic features of cervicofacial lymphatic malformations (LM) in children. Findings suggest distinct LM characteristics based on lymph node groupings, aiding diagnosis and treatment planning.
Area of Science:
- Pediatric Radiology
- Head and Neck Imaging
- Lymphatic Malformations
Background:
- Cervicofacial lymphatic malformations (LM) are congenital vascular anomalies.
- Accurate localization and characterization are crucial for effective management.
Purpose of the Study:
- To evaluate radiographic characteristics of pediatric cervicofacial lymphatic malformations.
- To identify common locations of these malformations based on known lymph node groupings.
Main Methods:
- Retrospective chart review of 90 pediatric patients with cervicofacial LM.
- Analysis of imaging data from MRI, CT, and US.
- Evaluation of demographic and imaging characteristics.
Main Results:
- Nearly half of LM were in the parotid/submandibular group, 32% in the cervical group, and 19% in the midline face/oral cavity group.
- Lesion morphology varied by location: midline (microcystic), parotid/submandibular (mixed), and cervical (macrocystic/mixed).
- Mixed lesions were more extensive and involved multiple lymph node groups.
Conclusions:
- Three distinct lymph node groupings are commonly associated with specific cervicofacial LM characteristics.
- This classification may aid in understanding disease progression and response to therapy.
- Further research is needed to validate the clinical significance of this classification.
Objectives:
To evaluate radiographic characteristics and to identify locations of cervicofacial lymphatic malformations in children based on known lymph node groupings.
Methods:
Retrospective chart review of pediatric patients with cervicofacial lymphatic malformations who underwent imaging with magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US). Ninety charts were reviewed from November 2005 to June 2015. Demographic information and imaging characteristics were evaluated.
Results:
Ninety children were included. The average age at presentation was 52 months (range, 1 day to 170 months). Imaging modalities were MRI in 73 (81%), CT in 7 (8%), US in 6 (7%), and multimodality imaging in 4 (4%) cases. Nearly half (49%) of lesions were found in the parotid and submandibular nodal group, 32% in the cervical group, and 19% in the midline face and oral cavity group. The lymphatic malformations were found on the left in 39 (43%) of cases, on the right in 30 (33%) of cases, and were bilateral in 21 (23%) cases. Nineteen (21%) lesions were macrocystic, twenty-two (24%) were microcystic, and forty-nine (49%) had mixed features. Mixed lesions were more likely to be extensive and involve multiple lymph node groups (P = 0.0005). Adjacent lymphadenopathy was present in 20 (22%) among all subjects, with an average size of 1.22 (± 1.92) cm in the short-axis.
Conclusion:
The results of this study demonstrate three lymph node groupings in which LM are commonly identified. The midline face and oral cavity lesions are predominantly microcystic, the parotid and submandibular lesions are predominately of mixed morphology, and the cervical lesions are predominately macrocystic and mixed. Further studies are needed to determine if such a classification system demonstrates clinically significant difference in disease progression and response to therapy.
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