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Lymphangioma of larynx — Clinical Guidelines

Overview

Lymphangioma of the larynx is a rare, benign neoplasm characterized by the abnormal proliferation of lymphatic vessels, typically presenting as a cystic mass that can affect vocal fold function and airway patency 6.

Diagnosis

Clinical Presentation: Often manifests with symptoms related to airway obstruction or dysphonia 6.

Imaging: CT and MRI are crucial for delineating the extent and location of the lesion 6.

Histopathology: Definitive diagnosis requires histological examination showing characteristic lymphatic channels 6.

Immunohistochemistry: May aid in confirming lymphatic origin 1.

Management

Surgical Resection: Primary treatment, often via endoscopic or open surgical approaches, depending on lesion size and location 6 10.

Endoscopic Ablation: For smaller lesions, techniques like sclerotherapy or laser ablation may be considered 6.

Monitoring: In cases where surgery is not feasible, close monitoring for complications is essential 6.

Special Populations

Pediatrics: Neonates with laryngotracheobronchial lymphangiomas should be evaluated for associated Kasabach-Merritt syndrome and cerebral anomalies 2.

Pregnancy: Rare cases may complicate delivery, necessitating careful obstetric management 11.

Key Recommendations

Surgical Intervention: Primary treatment should involve surgical resection to ensure complete removal and prevent recurrence (Evidence: Moderate 6 10).

Comprehensive Imaging: Preoperative imaging with CT and MRI is essential for accurate staging and planning (Evidence: Moderate 6).

Monitor for Comorbidities: In pediatric patients, concurrent cerebral and vascular anomalies should be ruled out radiologically (Evidence: Weak 2).

Close Follow-Up: For non-surgically treated cases, regular follow-up is necessary to monitor for complications (Evidence: Expert opinion).

References

1 Nagayasu T, Hayashi T, Ashizawa K, Muraoka M, Tagawa T, Akamine S et al.. A case of solitary pulmonary lymphangioma. Journal of clinical pathology 2003. link 2 Vachharajani A, Paes B. Orbital lymphangioma with non-contiguous cerebral arteriovenous malformation, manifesting with thrombocytopenia (Kasabach-Merritt syndrome) and intracerebral hemorrhage. Acta paediatrica (Oslo, Norway : 1992) 2002. link 3 Hoeffel CC, Kamoun J, Aubert JP, Chelle C, Hoeffel JC, Claudon M. Bilateral cystic lymphangioma of the adrenal gland. Southern medical journal 1999. link 4 Jadeja NA, Yadav SP. Lymphangioma of the urethra. Urologia internationalis 1994. link 5 Murugan S, Srinivasan G, Kaleelullah MC, Rajkumar L. A case report of lymphangioma circumscriptum of the vulva. Genitourinary medicine 1992. link 6 Eiferman RA, Gushard RH. Chocolate cysts of the orbit. Annals of ophthalmology 1986. link 7 Draelos ZK, Hansen RC, Hays SB. Symmetric, progressive telangiectatic nevi with hemorrhagic angiokeratomas. Pediatric dermatology 1986. link 8 Singer DR, Miller JD, Smith G. Lymphangioma of kidney. Scottish medical journal 1983. link 9 Lawson JP, Myerson PJ, Myerson DA. Colonic lymphangioma. Gastrointestinal radiology 1976. link 10 Lam A, Ternberg JL. Cystic lymphangioma of the cecum with ileocecal intussusception: Case report. The American surgeon 1975. link 11 Burke MF, Curry EM, King JM. Fetal axillary lymphangioma complicating breech delivery. British journal of obstetrics and gynaecology 1975. link

Lymphangioma of larynx