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Lower-Extremity LymphangiomatosisA Case Report with a Seventeen-Year Follow-up
Karl Schultz, MD1; Andrew E. Rosenberg, MD1; David H. Ebb, MD1; Henry J. Mankin, MD1
1 Departments of Orthopaedic Surgery (K.S. and H.J.M.) and Pathology (A.E.R.) and Pediatric Hematology-Oncology Service (D.H.E.), Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for H.J. Mankin: hmankin@partners.org
The Journal of Bone & Joint Surgery.  2005; 87:162-167  doi:10.2106/JBJS.D.01892
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Extract

Lymphangiomatosis is a rarely encountered syndrome from the category of diffuse, benign neoplasms1. The lesions are believed to result from abnormal development and proliferation of the lymphatic system1-4. The most common areas of involvement are the mediastinum, lung, heart, pleura, pericardium, and, less commonly, bone, including the vertebrae and ribs1-11. Skeletal involvement usually consists of multiple rounded, cystic lesions that most commonly occur in the femur and pelvis1,6,11-13. The lesions can be classified into three categories: (1) lymphangioma simplex lesions, which are composed of capillary sized, thin-walled lymphatic channels usually affecting the skin1,6,7; (2) cystic lymphangiomas or hygromas, which are fluid-filled lesions ranging from a few millimeters to many centimeters in size and most commonly occur in the axilla or neck1,14-16; and (3) lymphangioma cavernosum, which consists of dilated lymphatic channels often with fibrous adventitial coats and which usually affects visceral organs and bone17. All three types can be present simultaneously in patients with lymphangiomatosis1,4. The family of the patient was informed that data concerning the case would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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