Intraosseous lymphangiomas of the mandible

Isolated femoral osseous megalymphatics with chylous reflux: case report and review of the literature

We report here the clinical and imaging findings of marked dilatation of the intraosseous lymphatic vessels, "megalymphatics," with chylous reflux presenting with pain and extensive lytic changes in a femoral bone of a child. Multimodality imaging findings, including radiographs, magnetic resonance imaging, ultrasound, scintigraphy and percutaneous osseous lymphangiography are described.

A rare case of lumbar vertebral lymphangioma presenting as chylothorax

BACKGROUND CONTEXT

The lumbar lymphangioma occurs rarely. Several studies have presented cases with the involvement of multiple vertebrae in presence or absence of the other bones and/or adjacent soft tissue. We elucidate a rare case of lumbar lymphangioma which presents as chylothorax.

PURPOSE

To report a rare case of lumbar lymphangioma presenting as chylothorax.

STUDY DESIGN

A case report.

METHODS

A 32-year-old man was admitted with lumbar and chest pain. Lumbar plain radiography, computed tomography (CT) scan and magnetic resonance imaging revealed L2 vertebra's sclerosis and destruction with canal compression leading up to vertebral lymph/hemangioma impression. Chest radiograph revealed a left-sided pleural effusion that further examination confirmed the chylothorax. Because of medical treatment failure in managing the chylothorax, surgical exploration was performed on. The involved vertebra was resected and stabilized with a mass ligation of its adjacent soft tissues. Histopathologic study of the resected material confirmed the diagnosis of lymphangioma. Serial plain radiography and CT scan were performed at postoperative follow-up.

RESULTS

Following up assessments showed that the chylothorax resolved. Also, the pain significantly relieved.

CONCLUSION

To the authors' knowledge, this is a unique reported case of lymphangioma affecting lumbar vertebral body presenting as chylothorax. Further observation is recommended because of the possibility of local recurrence.

Imaging characteristics of neoplasms and other lesions of the jawbones

Obtaining an accurate diagnosis of odontogenic tumor-mimickers (nonodontogenic lesions masquerading as odontogenic lesions) and tumor-like lesions of the jawbones can be difficult and requires a multidisciplinary approach. Lack of familiarity with these disease processes may lead to uncertainty and errors in diagnosis, which increase the possibility of errors in treatment. Radiologists should be aware of the imaging appearances of lesions affecting the jawbones in order to provide a complete differential diagnosis and to guide clinicians in proper patient treatment. The morphologic characteristics of tumors and tumor-like lesions of the jawbones may provide key diagnostic information regarding the aggressive or nonaggressive biologic behavior of such lesions. In addition to imaging findings, thorough physical examination and, often, histologic analysis of biopsy specimens are required.

Primary non-odontogenic tumors of the jawbones: an overview of essential radiographic findings

The jawbones, namely the maxilla and mandible, can be the sites of a multitude of neoplastic conditions. Given the variety of processes affecting this particular anatomic area, formulation of a precise diagnosis often can be challenging to the radiologist and the clinician, who may not be familiar with the imaging findings fundamental to diagnosis. Although advanced imaging methods have been developed, routine radiography remains the mainstay in the initial assessment of osseous lesions involving the jawbones. We review and summarize the imaging appearances of non-odontogenic tumors of the jawbones and illustrate example cases of these uncommon neoplasms of bone. Detailed patient history, physical examination, laboratory evaluation and histopathologic analysis are of paramount importance in diagnostic approach and, in most cases, are to be considered in the imaging evaluation of a given lesion. Correct interpretation of the imaging features of lesions involving the jawbones suggests the diagnosis, aids in presurgical planning and improves patient management.

Solitary lymphangioma of the femur. A case report

Lymphangioma of the bone is a benign lesion, characterized by newly formed lymph vessels. It usually occurs in a diffuse manner or as multiple lesions. Solitary lymphangioma of the bone is an extremely rare condition. We herein describe a case of solitary lymphangioma of the femur in a 55-year-old woman who presented with knee pain. Radiographs showed an eccentric osteolytic lesion in the distal femur. This is the first reported case of solitary lymphangioma of the bone occurring in the femur.

Lymphangioma involving the mandible: immunohistochemical expressions for the lymphatic proliferation

We report a case of lymphangioma involving oral mucosa and mandible of an elderly female. The surgical and radiological examinations indicated that the lymphangioma was mainly distributed in the labial mucosa tissue, but had gradually extended into the periosteum and intrabony space of mandible. Immunohistochemical staining was also performed using antiseras of alpha-smooth muscle actin (alpha-SMA), von Willebrand factor (vWF), angiogenin, vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA) to elucidate the pathogenetic implications of the intraosseous lymphangioma. The present case of lymphangioma showed strong immunohistochemical reactivity of angiogenin and vWF, while it showed weak reactions of VEGF and PCNA. The immunostaining of alpha-SMA disclosed an abnormally thinned and discontinuous smooth muscle layer in the lymphatics. Both the X-rays and histological examination showed that the lymphangioma lesion was gradually extending into the adjacent osteoporotic marrow space of mandible. Therefore, we believe that the present case of intraosseous lymphangioma, which showed the harmatomatous growth of the lymphatics into the marrow space of mandible, is closely related to osteoporotic changes of old age.