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Cystic Hygroma and Lymphatic Malformations

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Abstract

Lymphatic malformations (LMs) are uncommon congenital low-flow vascular anomalies previously referred to as lymphangiomas or cystic hygromas. The terminology of vascular and lymphatic lesions needs to be standardized. Vascular and lymphatic lesions, in general, have been notoriously difficult for pathologists to diagnose and classify because of the large number of entities and their variants, and their frequently overlapping clinical and histopathologic features. This problem has been compounded by imprecise terminology with various names referring to the same lesion or, conversely, a particular term denoting different entities. Recently, the International Society for the Study of Vascular Anomalies (ISSVA), an organization comprised of specialists in various disciplines interested in vascular anomalies, approved a novel classification of vascular lesions that distinguishes malformations from tumors and provides an easily understood and concise nomenclature.

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References

  1. Enjolras O, Mulliken JB. Vascular tumors and vascular malformations (new issues). Adv Dermatol. 1997;13:375–423.

    CAS  Google Scholar 

  2. Wassef M, Blei F, Adams D, et al. Vascular anomalies classification: recommendations from the international society for the study of vascular anomalies. Pediatrics. 2015;136:e203–14.

    Article  Google Scholar 

  3. Landing BH, Farber S. Tumors of the cardiovascular system, Sec 3. Atlas of tumor pathology, vol 7. Washington, DC: United States Armed Forces Institute of Pathology, 1956. p. 124–35.

    Google Scholar 

  4. Poldervaart MT, Breugem CC, Speleman L, Pasmans S. Treatment of lymphatic malformations with OK-432 (Picibanil): Review of the literature. J Craniofac Surg. 2009;20:1159–62.

    Article  Google Scholar 

  5. Sichel JY, Udassin R, Gozal D, et al. OK-432 therapy for cervical lymphangioma. Laryngoscope. 2004;114:1805–9.

    Article  CAS  Google Scholar 

  6. Shiels WE II, Kenney BD, Caniano DA, Besner GE. Definitive percutaneous treatment of lymphatic malformations of the trunk and extremities. J Pediatr Surg. 2008;43:136–40.

    Article  Google Scholar 

  7. Giguère CM, Bauman NM, Sato Y, Burke DK, Greinwald JH, Pransky S, et al. Treatment of lymphangiomas with OK-432 (Picibanil) sclerotherapy: a prospective multi-institutional trial. Arch Otolaryngol Head Neck Surg. 2002;128:1137–44.

    Article  Google Scholar 

  8. Ogita S, Tsuto T, Nakamura K, Degichi E, Iwai N. OK-432 therapy in 64 patients with lymphangioma. J Pediatr Surg. 1994;29:784–5.

    Article  CAS  Google Scholar 

  9. Okazaki T, Iwatani S, Yanai T, Kobayashi H, Kato Y, Marusasa T, Lane GJ, Yamataka A. Treatment of lymphangioma in children: our experience of 128 cases. J Pediatr Surg. 2007;42:386–9.

    Article  Google Scholar 

  10. Gallagher PG, Mahoney MJ, Gosche JR. Cystic hygroma in the fetus and newborn. Semin Perinatol. 1999;23:341–56.

    Article  CAS  Google Scholar 

  11. Chervenak FA, Isaacson G, Blakemore KJ, Breg WR, Hobbins JC, Berkowitz RL, Tortora M, Mayden K, Mahoney MJ. Fetal cystic hygroma. Cause and natural history. N Engl J Med. 1983;309:822–5.

    Article  CAS  Google Scholar 

  12. McGill TJ, Mulliken JB. Vascular anomalies of the head and neck. In: Cummings CW, Friedrickson JM, Harker LA, et al., editors. Otolaryngology–head and neck surgery, vol 1. 2nd ed. St. Louis: Mosby; 1993. p. 333–46.

    Google Scholar 

  13. Zanotti SD, LaRusso S, Coulson C. Prenatal sonographic diagnosis of axillary cystic lymphangiomas. J Clin Ultrasound. 2001;29:112–5.

    Article  CAS  Google Scholar 

  14. Goldstein I, Leibovitz Z, Noi-Nizri M. Prenatal diagnosis of fetal chest lymphangioma. J Ultrasound Med. 2006;25:1437–40.

    Article  Google Scholar 

  15. Suzuki N, Tsuchida Y, Takahashi A, Kuroiwa M, Ikeda H, Mohara J, et al. Prenatally diagnosed cystic lymphangioma in infants. J Pediatr Surg. 1998;33:1599–604.

    Article  CAS  Google Scholar 

  16. Wiswell TE, Miller JA. Infections of congenital cervical neck masses associated with bacteremia. J Pediatr Surg. 1986;21:173–4.

    Article  CAS  Google Scholar 

  17. Feins NR. Lymphatic disorders. In: O’Neill Jr JA, et al., editors. Pediatric surgery. 5th ed. St Louis: Mosby; 1998. p. 1973–81.

    Google Scholar 

  18. Legiehn GM, Heran MK. Classification, diagnosis, and interventional radiologic management of vascular malformations. Orthop Clin North Am 2006; 37:435,74, vii–viii.

    Article  Google Scholar 

  19. Perkins JA, Maniglia C, Magit A, Sidhu M, Manning SC, Chen EY. Clinical radiographic findings in children with spontaneous lymphatic malformation regression. Otolaryngol Head Neck Surg. 2008;128:772–7.

    Article  Google Scholar 

  20. Smith RJH. Lymphatic malformations. Lymphat Res Biol. 2004;2:25–31.

    Article  Google Scholar 

  21. Hancock BJ, St-Vil D, Luks FI, et al. Complications of lymphangiomas in children. J Pediatr Surg. 1992;27:220–6.

    Article  CAS  Google Scholar 

  22. Lee BB, Kim YM, Seo JM, Hwang JH, et al. Current concepts in lymphatic malformation. Vasc Endovascular Surg. 2005;39:67–81.

    Article  CAS  Google Scholar 

  23. Perkins JA, Mannin SC, Tempero RM, Cunningham MJ, Edmonds JL, Hoffer FA, Egbert MA. Lymphatic malformations: review of current treatment. Otolaryngol Head Neck Surg. 2010;142:795–803.

    Article  Google Scholar 

  24. Ogita S, Tsuto T, Tokiwa K, Takahashi T. Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children. Br J Surg. 1987;74:690–1.

    Article  CAS  Google Scholar 

  25. Orford J, Barker A, Thonell S, King P, Murphy J. Bleomycin therapy for cystic hygroma. J Pediatr Surg. 1995;30:1282–7.

    Article  CAS  Google Scholar 

  26. Okada A, Kubota A, Fukazawa M, Imura K, Kamata S. Injection of bleomycin as a primary therapy of cystic lymphangioma. J Pediatr Surg. 1992;27:440–3.

    Article  CAS  Google Scholar 

  27. Castañón M, Margarit J, Carrasco R, Vancells M, Albert A, Morales L. Long-term follow-up of nineteen cystic lymphangiomas treated with fibrin sealant. J Pediatr Surg. 1999;34:1276–9.

    Article  Google Scholar 

  28. Riche MC. Traitement ono chirurgical des lymphangiomas kystiques. Ann Otolaryngol. 1986;103:67–70.

    CAS  Google Scholar 

  29. Alomari AI, Karian VE, Lord DJ, Padua HM, Burrows PE. Percutaneous sclerotherapy for lymphatic malformations: A retrospective analysis of patient-evaluated improvement. J Vasc Interv Radiol. 2006;17:1639–48.

    Article  Google Scholar 

  30. Luo QF, Gan YH. Pingyangmycin with triamcinolone acetonide effective for treatment of lymphatic malformations in the oral and maxillofacial region. J Craniomaxillofac Surg. 2013;41:345–9.

    Article  CAS  Google Scholar 

  31. Dubois J, Garel L, Abela A, Laberge L, Yazbeck S. Lymphangiomas in children: percutaneous sclerotherapy with an alcoholic solution of zein. Radiology. 1997;204:651–4.

    Article  CAS  Google Scholar 

  32. Laranne J, Keski-Nisula L, Rautio R, Rautiainen M, Airaksinen M. OK-432 (Picibanil) therapy for lymphangioma in children. Eur Arch Otorhinolaryngol. 2002;259:274–8.

    Article  CAS  Google Scholar 

  33. Ogita S, Tsuto T, Nakamura K, Deguchi E, Tokiwa K, Iwai N. OK-432 therapy for lymphangioma in children: Why and how does it work? J Pediatr Surg. 1996;31:477–80.

    Article  CAS  Google Scholar 

  34. Umezawa H. Recent studies on biochemistry and action of bleomycin. In: Carter SK, Crooke ST, Umezawa H. editors. Bleomycin. current status and new developments. New York: Academic; 1978. p. 15–20.

    Google Scholar 

  35. Muir T, Kirsten M, Fourie P, et al. Intralesional bleomycin injection (IBI) treatment for haemangioma and congenital vascular malformations. Pediatr Surg Int. 2004;19:766–73.

    Article  CAS  Google Scholar 

  36. Ishida N, Hoshino T. A Streptcoccal preparation as a potent biological response modifier OK-432. 2nd ed. Amsterdam: Excerpta Medica; 1985. p. 1–5.

    Google Scholar 

  37. Tuchihashi Y, Ogita S. Histopathological study of the effect of OK-432 on lymphangioma of an infant. J Kyoto Pref Univ Med. 1993;102:1055–60.

    Google Scholar 

  38. Tanigawa N, Shimomatsuya T, Takahashi K, Inomata Y, Tanaka K, Satomura K, et al. Treatment of cystic hygroma and lymphangioma with the use of bleomycin fat emulsion. Cancer. 1987;60:741–9.

    Article  CAS  Google Scholar 

  39. Ogita S, Tsuto T, Deguchi E, Tokiwa K, Nagashima M, Iwai N. OK-432 therapy for unresectable lymphangiomas in children. J Pediatr Surg. 1991;26:263–70.

    Article  CAS  Google Scholar 

  40. Boardman SJ, Cochrane LA, Roebuck D, Elliott MJ, Hartley BEJ. Multimodality treatment of pediatric lymphatic malformations of the head and neck using surgery and sclerotherapy. Arch Otolaryngol Head Neck Surg. 2010;136:270:276.

    Article  Google Scholar 

  41. Smith RJH, Bruke DK, Sato Y, Poust RI, Kimura K, Bauman NM. OK-432 therapy for lymphangiomas. Arch Otolaryngol Head Neck Surg. 1996;122:1195–9.

    Article  CAS  Google Scholar 

  42. Rautio R, Keski-Nisula L, Laranne J, Laasonen E. Treatment of lymphangiomas with OK-432 (Picibanil). Cardiovasc Intervent Radiol. 2003;26:31–6.

    Article  Google Scholar 

  43. Ninh TN, Tx N. Cystic hygroma in children: a report of 126 cases. J Pediatr Surg. 1974;9:191–5.

    Article  Google Scholar 

  44. Heniford BT, Matthews BD, Sing RF, Backus C, Pratt B, Greene FL. Initial results with an electrothermal bipolar vessel sealer. Surg Endosc. 2001;15:799–801.

    Article  CAS  Google Scholar 

  45. Ono S, Tsuji Y, Baba K, Usui Y, Yanagisawa S, Maeda K. A New strategy for the treatment of refractory microcystic lymphangioma. Surg Today. 2014;44:1184–7.

    Article  Google Scholar 

  46. Roy S, Reyes S, Smith LP. Bipolar radiofrequency plasma ablation (Coblation) of lymphatic malformations of the tongue. Int J Pediatr Otorhinolaryngol. 2009;73:289–93.

    Article  Google Scholar 

  47. Ryu NG, Park SK, Jeong HS. Low power radiofrequency ablation for symptomatic microcystic lymphatic malformation of the tongue. Int J Pediatr Otorhinolaryngol. 2008;72:1731–4.

    Article  Google Scholar 

  48. Leboulanger N, Roger G, Caze A, Enjolras O, Denoyelle F, Garabedian EN. Utility of radiofrequency ablation for hemorrhagic lingual lymphangioma. Int J Pediatr Otorhinolaryngol. 2008;72:953–8.

    Article  Google Scholar 

  49. Jian XC. Surgical management of lymphangiomatous or lymphangiohemangiomatous macroglossia. J Oral Maxillofac Surg. 2005;63:15–9.

    Article  Google Scholar 

  50. Bloom DC, Perkins JA, Manning SC. Management of lymphatic malformations and macroglossia: results of a national treatment survey. Int J Pediatr Otorhinolaryngol. 2009;73:1114–8.

    Article  Google Scholar 

  51. Swetman GL, Berk DR, Vasanawala SS, et al. Sildenafil for severe lymphatic malformations. N Engl J Med. 2012;366:384–6.

    Article  CAS  Google Scholar 

  52. Ozeki M, Kanda K, Kawamoto N, et al. Propranolol as an alternative treatment option for pediatric lymphatic malformation. Tohoku J Exp Med. 2013;229:61–6.

    Article  CAS  Google Scholar 

  53. Akyuz C, Atas E, Varan A. Treatment of a tongue lymphangioma with sirolimus after failure of surgical resection and propranolol. Pediatr Blood Cancer. 2014;61:931–2.

    Article  Google Scholar 

  54. Singh P, Mundy D. Giant neonatal thoraco-abdominal lymphatic malformations treated with sildenafil: A case report and review of the literature. J Neonatal Perinatal Med. 2013;6:89–92.

    CAS  Google Scholar 

  55. Laforgia N, Schettini F, De Mattia D, et al. Lymphatic malformation in newborns as the first sign of diffuse lymphangiomatosis: successful treatment with sirolimus. Neonatology. 2016;109:52–5.

    Article  CAS  Google Scholar 

  56. Aalami OO, Allen DB, Organ CH Jr. Chylous ascites: a collective review. Surgery. 2000;128:761–78.

    Article  CAS  Google Scholar 

  57. Weinstein LD, Scanlon GT, Hersh T. Chylous ascites. Management with medium-chain triglycerides and exacerbation by lymphangiography. Am J Dig Dis. 1969;14:500–9.

    Article  CAS  Google Scholar 

  58. Ono S, Iwai N, Chiba F, Furukawa T, Fumino S. OK-432 therapy for chylous pleural effusion or ascites associated with lymphatic malformations. J Pediatr Surg. 2010;45:e7–10.

    Article  Google Scholar 

  59. Huang Q, Jiang ZW, Jiang J, et al. Chylous ascites: treated with total parenteral nutrition and somatostatin. World J Gastroenterol. 2004;10:2588–91.

    Article  CAS  Google Scholar 

  60. Collard JM, Laterre PF, Boemer F, et al. Conservative treatment of postsurgical lymphatic leaks with somatostatin-14. Chest. 2000;117:902–5.

    Article  CAS  Google Scholar 

  61. Cochran WJ, Klish WJ, Brown MR, et al. Chylous ascites in infants and children: A case report and literature review. J Pediatr Gastroenterol Nutr. 1985;4:668–73.

    Article  CAS  Google Scholar 

  62. Cardenas A, Chopra S. Chylous ascites. Am J Gastroenterol. 2002;97:1896–900.

    Article  Google Scholar 

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Correspondence to Shigeru Ono MD, PhD .

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Ono, S. (2018). Cystic Hygroma and Lymphatic Malformations. In: Losty, P., Flake, A., Rintala, R., Hutson, J., lwai, N. (eds) Rickham's Neonatal Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4721-3_55

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