Lymphangioma: imaging diagnosis

Lymphangiomas are congenital malformations of the lymphatics that are curable by extirpation. Accurate delineation of lesion extension is important for pre-operative diagnosis, surgical planning, and assessing recurrence. The radiologic findings were retrospectively evaluated to determine the imaging appearance of these benign tumours. The plain radiographs, barium meal, ultrasound, CT, and MR images of 18 patients with one or more pathologically proved lymphangiomas were reviewed. Plain radiography and barium study showed masses displacing adjacent organs. Ultrasound examination showed uni- or multilocular cystic masses with smooth, thin or irregular, thick walls. Enhancement of the cyst wall was variable on CT and MR studies. The CT density of the fluid ranged from -4 to 34 HU depending on the lipid content and the presence of haemorrhage. The cysts were isointense to muscle on T1-weighted and hyperintense to fat on T2-weighted MR images. The MR imaging delineated the tumour lesion extension more clearly than ultrasound and CT scans. Ultrasound, CT, and MR imaging are valuable for evaluating lymphangiomas. Magnetic resonance imaging allows accurate determination of lesion extension.