Lymphangioma (Differential Diagnosis as before)

metu_15_n.jpg: This picture shows a grey mass which continues in a reddish zone at the bottom. The mass is visible in the center of the picture above the lung retracted by two spatulas. Part of the lung is atelectatic and recognizable by the pattern of its surface !£metu_15_p£!. A cystic lymphangioma occurs mainly at the neck or in the craniofacial region. $$tuha_16??££See alternate figures§§. If parts of this cystic malformation tumor occur above the thoracic apperture or in the axilla, and a mass is visible in the mediastinum on x-ray, a cystic lymphangioma of the middle mediastinum can be diagnosed clinically. Mediastinal cystic lymphangioma may also lead to respiratory distress syndrome or to symptoms of the airways $$atno_8??££ by compression of the lung§§ due to a rapid increase in size following bleeding or lymph accumulation. In the presented case of a 6.7-year-old boy the cystic lymphangioma is located exclusively in the mediastinum. In such a case a CT or MRI is useful in addition to the plain x-ray of the thorax in two planes; it yields not only precise information for the pediatric surgeon about the site and extension of the mass, but also about the type and composition of the tumor in the middle of the mediastinum, in the presented case of a possible hemangioma or vascular component (notice the reddish zone). The grey mass is tight, and at the upper border a cyst is recognizable which is one of multiple typical small satellite cysts occurring in cystic lymphangioma.