Multiple cystically dilated lymphatics with pale pink intraluminal eosinophilic material comprise the lesion.
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The lining cells are attenuated and sometimes difficult to identify, and devoid of atypia. Lymphoid collections in the wall are typical.
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Mediastinal lymphangiomas are equally distributed between the anterior, middle and posterior regions. Histologically, they can be subdivided on the basis of size of the lymphatic channels, which include cystic (macrocystic), capillary (super-microcystic), and cavernous
(microcystic)(Faul).
Rare slow growing tumor which is usually asymptomatic and discovered incidentally on CXR performed for other reasons. Sometimes patients have symptoms due to compression such as cough, and/or
dyspnea. The lesions can insinuate around adjacent structures. MRI is the diagnostic modality of
choice, demonstrating lesions with heterogeneous signal intensity on T1-weighted images and high signa
intensity on T2-weighted images, reflecting their fluid content (Shaffer).
Does not recur if completely excised. Some recur if incompletely removed.
Faul JL, Berry GJ, Colby TV, Ruoss SJ, Walter MB, Rosen GD, et al. Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis,and lymphatic dysplasia syndrome. Am J Respir
Crit Care Med 2000;161:1037–46.
Shaffer K, Rosedo-de-Christenson ML, Patz EF Jr, Young S, Farver CF. Thoracic lymphangioma in adults: CT and MR imaging features. AJR Am J Roentgenol 1994;162:283–9.