THROAT - Cystic hygroma

What is Cystic Hygroma?                           
Definition: This is a congenital malformation affecting the lymphatic channel and arises from 'embryonic lakes' which are precursors of adult lymph channels.

Age: Often present at birth but are commonly seen in young children.

What are the clinical features of Cystic hygroma?                                        

  1. Young children
  2. A cystic swelling
  3. Margins not well defined
  4. Fluctuant
  5. Partially compressible
  6. Brilliantly transilluminant
  7. Regional lymph nodes are not enlarged

Usual sites of Cystic hygroma:
1)      Root of the neck in the posterior triangle, deep to sternomastoid is the     commonest site. It may extend to the cheek, mouth, tongue, parotid, ear or downwards towards the axilla and or mediastinum.
2)      Axilla
3)      Groin
4)      Mediastinum

Atypical Presentation:
1)      During birth, a big cystic hygroma may· cause obstructed labour
2)      It may present as a pyogenic abscess
3)      Cystic hygroma in the mediastinum may present as 'mediastinal     syndrome'

Histopathology:
Cystic Hygroma is lined by large multinodular cystic mucosa which may communicate or be single. The walls are thin and contain fluid. and contain fluid. Histologically, the cyst is lined by a single layer of flattened epithelium with foetal fat and cholesterol crystals. 

What is the treatment of Cystic hygroma?

MEDICAL

SURGICAL

Child can be observed for 2 years for
spontaneous remission

Aspiration followed by injection of hot water or hypertonic saline as
sclerosing agents

Excision of the cyst if no mediastinal extension

 First excision limited to cervical area

What is the Differential Diagnosis: of Cystic hygroma?

  1. Branchial Cysts
  2. Cold abscess in neck
  3. Collar stud abscess
  4. Solitary lymph cyst 

What is the complications: of Cystic hygroma?

1. Recurrent infection
2. Respiratory distress

Spontaneous remission has been seen after 24 years.

This tumor never turns malignant.




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