This involves superficial proliferation of capillary sized lymphatic vessels which comprise fluid-filled vesicles on the surface and larger cisternae in the subcutaneous tissues and even adjacent muscles. These clear or slightly haemorrhagic skin vesicles have been considered either as hamartomas or as a localised deficiency in skin lymphatic drainage. Affected skin and a generous amount of subcutaneous tissue containing the vessels may be excised if they cause symptoms, but even with generous margins recurrence is common.
Cystic hygroma is an abnormal lymph-filled, often multilocular, space which usually presents in childhood as a soft, brilliantly transluminable swelling in the base of the neck. It is also found in the head and inguinat regions as they develop from primitive lymph cisterns. It behaves like a benign tumour and grows gradually in size, leading to cosmetic problems and compression of surrounding structures. Recurrence is common after simple aspiration and injection of sclerosant. Excision is technically challenging due to the large number of vital structures in the vicinity.
Mesenteric lymph cysts
These cysts present as well-defined mobile lumps within the abdomen, the nature of which can be confirmed by either ultrasound or CT. They may be resected together with the overlying segment of small bowel if they cause symptoms.
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