Intrapulmonary cystic lymphangioma in a 2-month-old infant

Abstract

Lymphangioma is an abnormal collection of lymphatics that are developmentally isolated from the normal lymphatic system. Lymphangioma rarely presents as a solitary pulmonary lesion. We report a rare case of intrapulmonary cystic lymphangioma involving the upper lobe of the right lung, which presented with dyspnea in a 2-month-old infant. High-resolution computed tomography (HRCT) of the chest demonstrated a well-circumscribed, multiseptate, cystic lesion in the upper lobe of the right lung, mimicking the feature of type I congenital cystic adenomatoid mal-formation. The tumor was removed by bilobectomy of the upper and middle lobes of the right lung, and its pathologic examination confirmed the diagnosis of an intra-pulmonary cystic lymphangioma.

Fig. 1

High-resolution computed tomography of the chest depicts a well-circumscribed, multiseptate, air-filled cystic lesion in the upper lobe of the right lung.

Fig. 2

1:1 scaned photograph shows a large intrapulmonary cystic tumor (Ly), causing emphysematous change (Em) in surrounding pulmonary parenchyma (H&E, ×1).

Fig. 3

The cystic walls (in the right top) of the tumor are supported by loose fibrous tissue and adjoin to the emphysematous lung tissue (in the left) (H&E, ×20).

Fig. 4

Immunohistochemical staining for factor VIII-related antigen shows weak positive reactions in the lining cells of the cystic walls (Streptavidin-biotin, ×100).