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Eur J Cardiothorac Surg 2002;21:340
© 2002 Elsevier Science NL

Images in cardio-thoracic surgery

Giant cystic lymphangioma of the mediastinum

Torsten Bossert*, Jan F. Gummert, Friedrich Wilhelm Mohr

Department of Cardiac Surgery, University of Leipzig – Heart Center, Russenstrasse 19, D-04289 Leipzig, Germany

Received 15 September 2001; received in revised form 9 November 2001; accepted 13 November 2001.

* Corresponding author. Tel.: +49-341-8650; fax: +49-341-865-1452
e-mail: tbossert11{at}aol.com

Key Words: Cystic lymphangioma • Mediastinum • Magnetic resonance imaging

A 43-year-old woman presented with respiratory distress. A chest roentgenogram revealed an abnormal shadow of the left hemithorax (Fig. 1 ). Magnetic resonance imaging (MRI) identified a giant non-invasive monomorphic cystic mass (Fig. 2 ).



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  		Fig. 1. Chest roentgenogram with a giant abnormal shadow.

 


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  		Fig. 2. MRI demonstrating the cystic mass in the left hemithorax.

 
A minithoracotomy was done. The mass extended from the superior mediastinum to the left hemithorax. The cyst was adherent to the left side of the thymus and the pericardium next to the phrenic nerve and could be completely resected without damaging the phrenic nerve. The pathohistological examination revealed a cystic lymphangioma with parts of thymic tissue.

Postoperative course was uneventful without signs of recurrence in follow-up.

Cystic lymphangioma in adults is an extremely rare mediastinal benign tumor which frequently occurs in children and young adults. It is generally regarded as a developmental malformation of lymphatic tissue. Only 1% is localized in the mediastinum; usually cystic lymphangiomas occurs in the neck (75%) or the axillary region (20%).

Treated by surgery, the prognosis remains good. However, a few local recurrences have been reported.




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