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Cystic hygromas in children: sonographic-pathologic correlation
Insights
Sonography effectively visualizes cystic hygromas, aiding in diagnosis and surgical planning. This imaging technique helps differentiate these lymphatic malformations from other masses and assess their extent.
Area of Science:
- Pediatric Radiology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Cystic hygromas are congenital lymphatic malformations often presenting as neck masses.
- Accurate diagnosis and staging are crucial for effective management.
- Distinguishing cystic hygromas from other pediatric soft tissue tumors can be challenging.
Purpose of the Study:
- To correlate sonographic findings with pathologic specimens in children with surgically confirmed cystic hygroma.
- To evaluate the utility of ultrasound in characterizing cystic hygromas and guiding surgical intervention.
Main Methods:
- Retrospective review of sonographic findings in eight children with surgically proven cystic hygroma.
- Correlation of imaging features with histopathologic examination of resected specimens.
Main Results:
- Cystic hygromas appeared as multiloculated cystic masses with variable septa and solid components.
- The echogenic component on ultrasound corresponded to microscopic abnormal lymphatic channels.
- Sonography demonstrated ill-defined boundaries in large lesions, with dissection between tissue planes.
- Ultrasound differentiated cystic hygromas from other cervical masses, including hemangiomas.
- Imaging accurately depicted lesion extent and aided in assessing postoperative outcomes.
Conclusions:
- Sonography is a valuable tool for diagnosing and characterizing pediatric cystic hygromas.
- Ultrasound facilitates surgical planning by defining lesion extent and relationship to surrounding structures.
- Sonographic assessment is useful for monitoring postoperative complications and recurrences.
Abstract:
The sonographic findings in eight children with surgically proved cystic hygroma were reviewed and correlated with the pathologic specimens. Six tumors occurred in the neck, one occurred in the axilla, and one involved the soft tissues of the thigh, scrotum, and pelvis. A cystic hygroma characteristically appears as a multiloculated cystic mass with septa of variable thickness that contain solid components arising from the cyst wall or the septa. Correlation of the sonogram with the pathologic specimen demonstrated that the echogenic component corresponded to a cluster of abnormal lymphatic channels, too small to be resolved with ultrasound. Large lesions had ill-defined boundaries, with cystic components dissecting between normal tissue planes. Sonographically, one can usually differentiate these tumors from other cervical masses, especially soft-tissue hemangiomas. Sonography is also helpful in determining the extent of the lesion before surgery and in assessing postoperative complications and recurrences.