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Lymphangioma (Lymphatic malformation) Benign fluid-filled spaces of lymphatic vessels Absence of erythrocytes (DDx hemorrhage), D2-40 Supporting stroma: collagen, lymphoid aggregates Capillary – mostly skin, uniform, small, thin-walled lymphatics Cavernous – variable size, connected to lymphatics, lymphoid stroma Cystic – not connected to lymphatics, a/w collagen, smooth muscle Macrocystic (larger than 2 cm, cavernous & cystic), microcystic, mixed Superficial (lymphangioma circumscriptum), deep seated Cavernous lymphangioma: Imaging features Combined macro- and microcystic Mimic solid mass on US & noncontrast CT Intervening fat and vessels Candy-cloud shape Cystic lymphangioma: Imaging features Macrocystic, a few septa No intervening fat or vessels Smooth and sharply defined margin Summary: Lymphangioma (lymphatic malformation) Lymphangioma is a ‘cystic’ mass The term, ‘cystic’ lymphangioma, may have dubious meaning Cavernous for mixed macro- & microcystic lymphangioma Cystic for macrocystic lymphangioma Cavernous lymphangioma may spontaneously regress Cystic lymphangioma may grow, not treatable by catheterization