The cisterna chyli, a dilated lymphatic sac in the retrocrural space, is usually located to the right of the aorta. We report a case of a left-sided cisterna chyli, which was incidentally detected on the radiologic examinations of a preoperative workup for cholangiocarcinoma. Computed tomography (CT) and magnetic resonance (MR) images revealed a cisterna chyli measuring 2.5 cm in length in the left retrocrural space. The dilated lumbar lymphatics joined with the cisterna chyli, which was continuous with the left-sided thoracic duct. To the best of our knowledge, this is the second antemortem case of a left-sided cisterna chyli in literature. The cisterna chyli can mimic retrocrural lymphadenopathy, solid tumor with cystic degeneration, abscess or hematoma. The left-sided cisterna chyli should be referred to as a structure so as to be cautious in surgical approach.
Abscess ; Aorta ; Cholangiocarcinoma ; Hematoma ; Lymphatic Abnormalities ; Lymphatic Diseases ; Thoracic Duct

Child, Preschool ; Humans ; Lymphatic Abnormalities ; diagnosis ; therapy ; Male ; Middle Aged

The presence of aberrant thyroid tissue in the lateral neck is very rare. In addition, nodular hyperplasia in ectopic thyroid has rarely been reported. Due to the unusual location, the presence of lateral aberrant thyroid tissue could be misdiagnosed as a lymphadenopathy, neurogenic tumor, etc. We report on a case of nodular hyperplasia arising from the right lateral aberrant thyroid tissue.
Congenital Abnormalities ; Hyperplasia ; Lymphatic Diseases ; Neck ; Thyroid Dysgenesis ; Thyroid Gland

Lymphatic malformation is a congenital abnormality of the lymphatic system, which manifests frequently at birth or before 2 years of age. Lymphatic malformations are classified as macrocystic or microcystic. Microcystic lesions typically occur above the level of mylohyoid muscle and need conservative treatment rather than surgical resection because of the high rate of incomplete excision and recurrence. We report our experience with two cases of radiofrequency ablation of lymphatic malformation in the oral cavity recently seen in our practice.
Congenital Abnormalities ; Lymphatic System ; Mouth ; Muscles ; Parturition ; Recurrence

Microcystic lymphatic malformation (lymphangioma circumscriptum) is the most common cutaneous lymphatic malformation, consisting of abnormal, dilated, and tortuous lymphatic vessels in the dermis and subcutaneous tissue. It is due to irregular vessel contraction with subsequent dilatation and fluid build-up that manifests clinically as multiple, grouped, small macroscopic superficial vesicles filled with clear or serosanguineous fluid. The lesions are frequently located over proximal limbs, axillae and chest but may occur on any part of the body. We report a case of lymphangioma circumscriptumin a four-year-old child, partially treated with fractional carbon dioxide laser ablation under local anesthesia. Most of the lesions resolved but the treated areas healed with hypertrophic scarring after one month, which was cosmetically acceptable. Compared to surgical excision, carbon dioxide laser ablation may provide less chances of contractures especially in areas overlying a joint and may be considered as an alternative to more invasive procedures.

Human ; Female ; Child Preschool ; Anesthesia, Local ; Axilla ; Cicatrix ; Contracture ; Dermis ; Dilatation ; Lasers, Gas ; Lymphangioma ; Lymphatic Abnormalities ; Lymphatic Vessels ; Subcutaneous Tissue

Lymphangiomatosis is a condition of lymphatic tissue malformation with multiple or diffuse involvement of soft tissues, visceral organs. Congenital abnormalities of the lymphatic system are very rare, and reports of congenital lymphangiomatosis are even fewer. We experienced a case of congenital lymphangiomatosis detected as edema of the right limb by prenatal ultrasonography and then diagnosed by magnetic resonance imaging. We describe this case with a brief review of the literature.
Congenital Abnormalities ; Edema ; Extremities ; Lower Extremity ; Lymphatic System ; Lymphoid Tissue ; Magnetic Resonance Imaging ; Ultrasonography, Prenatal

BACKGROUND: Lymphatic malformation (LM) is a form of congenital vascular malformation with a low incidence. Although LM has been studied, no consensus has emerged regarding its cause or treatment. METHODS: In this study, we retrospectively evaluated 40 patients who visited our vascular anomalies center for the treatment of cervicofacial LM, which is a common manifestation of LM. The medical records of patients over a period of 12 years were reviewed and analyzed for commonalities regarding the diagnosis and the results of treatment. RESULTS: Suspected cervicofacial LM was confirmed through imaging studies. No difference in incidence was observed according to sex, and 73% of patients first presented with symptoms before the age of two years. The left side and the V2-V3 area were most commonly affected. No significant differences in incidence were observed among the macrocystic, microcystic, and combined types of LM. A total of 28 out of 36 patients received sclerotherapy as the first choice of treatment, regardless of the type of lesion. Complete resolution was achieved in only 25% of patients. CONCLUSIONS: LM is important to confirm the diagnosis early and to choose an appropriate treatment strategy according to the stage of the disease and each individual patient's symptoms. When treatment is delayed or an incorrect treatment is administered, patient discomfort increases as the lesion gradually spreads. Therefore, more so than is the case for most other diseases, a team approach on a case-by-case basis is important for the accurate and appropriate treatment of LM.
Consensus ; Diagnosis ; Humans ; Incidence ; Lymphangioma ; Lymphatic Abnormalities ; Medical Records ; Retrospective Studies* ; Sclerotherapy ; Vascular Malformations

Lymphatic malformations including macrocystic and microcystic malformation are congenital benign vascular disease. The incidence in children is much higher than adults and they most often occur in head and neck. There are a variety of diagnosis and treatment methods in lymphatic malformations. This paper reviewed the recent literatures with respect to the pathology, imaging and treatment of the lymphatic malformations in children. And we detailed the advantage and disadvantage of surgical excision, sclerotherapy, laser ablation and drug treatment of lymphatic malformations particularly in children. Surgical excision continues to be integral to treat in many cases when the lesions involve the eye socket or are large enough to affect breathing, but it should not be overused without consideration of the histologic types and extent. In addition, cervicofacial macrocystic lesions tend to sclerotherapy while superficial mucosal microsystic lesions are amenable to laser therapy. In order to obtain the best treatment outcomes, the treatment protocol should be individualized and comprehensive.
Child ; Head ; pathology ; Humans ; Laser Therapy ; Lymphatic Abnormalities ; diagnosis ; therapy ; Neck ; pathology ; Sclerotherapy ; Treatment Outcome

INTRODUCTION: Lymphedema develops due to the abnormality of the transport capacity of the lymphatic system. Clinically lymphedema is not only a cosmetic deformity, but also a disabling and distressing condition. CLASSIFICATION: Primary lymphedema is an inborn defect caused by such condition as absence or underdevelopment of the lymphatic system. It occurs in approximately 1 in 10,000 persons less than 20 years of age, with females being affected more frequently than males. Secondary lymphedema is an acquired condition resulting from loss or obstruction of the previously normal lymphatic system due to infection, tumor, filariasis and other miscellaneous conditions. CLINICAL FEATURES: Clinical symptoms and signs depend on the duration and the severity of the lymphedema. In the early stage of disease, the edema is soft and pits easily with pressure (pitting edema) and may decrease or disappear with elevation of the limbs. In the advanced stage, the skin texture turns woody as the surrounding tissue becomes indurated and fibrotic. DIAGNOSIS: Lymphangiography was introduced in the early 19th century. But there are several drawbacks to this procedure, including the complexity of the procedure, irradiation by contrast agent that may result in lymphangitis and potentially worsen the lymphedema. Lymphoscintigraphy is easier to perform than lymphangiography and is not reported to cause lymphangitis. Lymphoscintigraphy is gradually replacing lymphangiography. TREATMENT: The mainstay of the treatment is complex decongestive physical therapy including leg elevation, elastic or rigid compression, manual lymph drainage, and intermittent pneumatic compression. When the function of the limb is significantly impaired, surgical reduction is considered. The surgery is not curative, but it can make the disorder more manageable by complex decongestive physical therapy.
Classification ; Congenital Abnormalities ; Diagnosis ; Drainage ; Edema ; Extremities ; Female ; Filariasis ; Humans ; Leg ; Lymphangitis ; Lymphatic System ; Lymphedema* ; Lymphography ; Lymphoscintigraphy ; Male ; Skin

Anticonvulsant hypersensitivity syndrome is a life threatening immunologic reaction of anticonvulsants therapy such as phenytoin, phenobarbital, or carbamazepine, characterized by multiple abnormalities such as fever, rash, lymphadenopathy, acute hepatocellular injury, leukocytosis, and eosinophilia. We report a case of anticonvulsant hypersensitivity syndrome thought to be caused by the use of carbamazepine in a 65-year-old male. He developed erythematous skin eruption four weeks after beginning therapy with carbamazepine. The clinical, laboratory and histologic findings of this patient were compatible with anticonvulsant hypersensitivity syndrome.
Abnormalities, Multiple ; Aged ; Anticonvulsants ; Carbamazepine* ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity* ; Leukocytosis ; Lymphatic Diseases ; Male ; Phenobarbital ; Phenytoin ; Skin