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Prenatal Diagnosis of Fetal Chest Lymphangioma

Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel (I.G., M.N.-N.); Department of Obstetrics and Gynecology, B’nai Zion Medical Center, Haifa, Israel (Z.L.); and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (I.G., Z.L., M.N.-N.).

Address correspondence to Israel Goldstein, MD, Department of Obstetrics and Gynecology, Rambam Medical Center, PO Box 9602, 31096 Haifa, Israel.

Objective. Prenatally diagnosed cystic nuchal hygroma is often associated with chromosomal anomalies and hydrops fetalis. Chest lymphangioma diagnosed later in gestation appears to be a completely different disease, with a low incidence of chromosomal and structural anomalies. Methods. Two chest cavernous lymphangiomas of the fetus are presented. The sonographic images, chromosomal analyses, and macroscopic and microscopic evaluations are described. Results. Fetal chest cavernous lymphangiomas were identified at 15 and 22 weeks’ gestation. In the first case, the couple decided to interrupt gestation. In the second case, prenatal sonography showed a multilocular, cystic lymphangioma external to the chest wall with no flow on Doppler sonography. Follow-up sonography revealed normal fetal growth and slow enlargement of the cystic mass surrounding the left chest cavity. The neonate was delivered without complications and was treated surgically. Conclusions. The chest lymphangioma appears to be a lesion usually not associated with other congenital abnormalities. The prenatal diagnosis of chest wall lymphangioma is relatively easy sonographically, and the treatment of choice is surgical excision. The outcome is relatively favorable, with a low incidence of chromosomal and structural anomalies.

Key Words: chest lymphangioma • cystic hygroma • fetus • lymphangioma • lymphatic system