Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Radiographic, CT, and MRI Features of Generalized Lymphatic Anomaly in a Boy

Author(s): Changwei Ding* and Yue Wang

Volume 19, Issue 2, 2023

Published on: 20 August, 2022

Article ID: e160522204845 Pages: 5

DOI: 10.2174/1573405618666220516124623

Price: $65

Abstract

Background: Generalized lymphatic anomaly (GLA) is a rare condition, mainly involving bones, soft tissue, and internal organs. The diagnosis of GLA is often difficult.

Case Presentation: We report a case of GLA in a boy who was initially treated for suspected Langerhans cell histiocytosis and discuss the potential imaging features of GLA. The clinical and imaging data of a case of GLA in an 8-year-old boy were analyzed retrospectively, and the literature was reviewed.

Results: The case shows the imaging features of GLA with multiskeletal diffuse expansile cystic osteolytic lesions penetrating the cortical surface and extending within the cortex and a pumice-like or rotten wood-like rough appearance on volume-rendered 3D CT images. Soft tissue multi-cystic masses increase diagnostic confidence. Fatty infiltration appears in multiple vertebral bodies and sternum, namely, abnormal T1 and T2 hyperintense and fat-suppressed T2 hypointense on MRI and the corresponding low density similar to that of fat on CT, suggesting that GLA involves the vertebrae and sternum, which may be accompanied by chylothorax.

Conclusion: GLA in bone has typical features on CT. MRI reveals its cystic nature, and typical soft tissue lesions and chylothorax increase confidence in the diagnosis.

Keywords: generalized lymphatic anomaly, lymphangiomatosis, bone, CT, MRI

[1]
ISSVA. Amsterdam: International society for the study of vascular anomalies. ISSVA classification for vascular anomalies. Available from: http://www.issva.org/classification
[2]
Luisi F, Torre O, Harari S. Thoracic involvement in generalised lymphatic anomaly (or lymphangiomatosis). Eur Respir Rev 2016; 25(140): 170-7.
[http://dx.doi.org/10.1183/16000617.0018-2016] [PMID: 27246594]
[3]
Sun X, Shen W, Xia S, Wen T, Wang R. Diffuse pulmonary lymphangiomatosis: MDCT findings after direct lymphangiography. AJR Am J Roentgenol 2017; 208(2): 300-5.
[http://dx.doi.org/10.2214/AJR.16.16589] [PMID: 27845836]
[4]
Uribe R, Isaza S, Prada V, Cadavid L, Quiceno W. Lymphangiomatosis in a 14-year-old female presenting with chylothorax and multiple cystic lesions. Radiol Case Rep 2018; 13(4): 782-7.
[http://dx.doi.org/10.1016/j.radcr.2018.05.002] [PMID: 30002781]
[5]
Yang DH, Goo HW. Generalized lymphangiomatosis: radiologic findings in three pediatric patients. Korean J Radiol 2006; 7(4): 287-91.
[http://dx.doi.org/10.3348/kjr.2006.7.4.287] [PMID: 17143033]
[6]
Renjen P, Kovanlikaya A, Narula N, Brill PW. Importance of MRI in the diagnosis of vertebral involvement in generalized cystic lymphangiomatosis. Skeletal Radiol 2014; 43(11): 1633-8.
[http://dx.doi.org/10.1007/s00256-014-1935-1] [PMID: 24950879]
[7]
Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans’ cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol 2005; 35(2): 103-15.
[http://dx.doi.org/10.1007/s00247-004-1262-0] [PMID: 15289942]
[8]
Lala S, Mulliken JB, Alomari AI, Fishman SJ, Kozakewich HP, Chaudry G. Gorham-Stout disease and generalized lymphatic anomaly--clinical, radiologic, and histologic differentiation. Skeletal Radiol 2013; 42(7): 917-24.
[http://dx.doi.org/10.1007/s00256-012-1565-4] [PMID: 23371338]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy