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Oral Lymphangiomas Clinical Presentation

  • Author: Kruti Parikh; Chief Editor: William D James, MD  more...
 
Updated: Feb 12, 2015
 

History

Although most lesions appear in the individual's first 2 years of life, lesions occasionally appear in early adulthood. Typical histories include annoying and repetitive surface bleeding, feeding difficulties in infancy, paroxysms of lesion expansion (usually in association with upper respiratory tract infections), intralesional hemorrhage, macroglossia, or repeated infections.[13]

Oral lymphangiomas can be seen in association with Turner syndrome, Noonan syndrome, various trisomies, fetal hydrops, and fetal alcohol syndrome. A thorough medical and family history can help rule out these associated syndromes.[14]

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Physical

The clinical appearance of the lymphatic malformations generally depends on the depth of extension. Superficial lymphatic malformations have a pebbly surface and are usually pink or yellow, with the appearance of grouped translucent vesicles. Some may also be bluish, which may be caused by either a venous component or an intralesional hemorrhage.

See the images below.

Superficial lymphatic malformation. Superficial lymphatic malformation.
Superficial lymphatic malformation. Superficial lymphatic malformation.

Deeper lesions may have a superficial component. When a superficial component is absent, deeper lesions usually appear as soft, ill-defined masses that markedly distort the local anatomy.

See the images below.

Marked lingual enlargement caused by lymphatic malMarked lingual enlargement caused by lymphatic malformation. Note the pebbly surface in areas not covered by materia alba. Also note the ecchymotic lesions protruding from the buccal mucosa in the mandibular vestibules.
Note the significant left buccal and submandibularNote the significant left buccal and submandibular swelling.
Profile view of a young adult with oral lymphangioProfile view of a young adult with oral lymphangioma (same patient as in Media File 2).

Macrocystic lesions may be fluctuant and readily transilluminating.

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Causes

Although no clear consensus on the mechanism for lesion development exists, the lesions likely develop as a result of aberrant sequestration of portions of these primitive embryonic anlagen. See Pathophysiology.

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Contributor Information and Disclosures
Author

Kruti Parikh Rutgers Robert Wood Johnson Medical School

Disclosure: Nothing to disclose.

Coauthor(s)

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Sean P Edwards, DDS, MD, FRCD(C) Assistant Professor, Chief of Pediatric Oral and Maxillofacial Surgery, Section of Oral and Maxillofacial Surgery, Department of Surgery, C S Mott Children's Hospital, University of Michigan Medical Center

Sean P Edwards, DDS, MD, FRCD(C) is a member of the following medical societies: Alpha Omega Alpha, American Association of Oral and Maxillofacial Surgeons, American Cleft Palate/Craniofacial Association, American Medical Association, International Association of Oral and Maxillofacial Surgeons, and Royal College of Dentists of Canada

Disclosure: Nothing to disclose.

Joseph Helman, DMD Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Michigan

Joseph Helman, DMD is a member of the following medical societies: American Association of Oral and Maxillofacial Surgeons, American Cleft Palate/Craniofacial Association, American College of Oral and Maxillofacial Surgeons, American Head and Neck Society, and International Academy of Oral Oncology

Disclosure: Nothing to disclose.

Smeena Khan, MD Private Practice, Adult and Pediatric Dermatology Associates

Smeena Khan, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

References
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Marked lingual enlargement caused by lymphatic malformation. Note the pebbly surface in areas not covered by materia alba. Also note the ecchymotic lesions protruding from the buccal mucosa in the mandibular vestibules.
Note the significant left buccal and submandibular swelling.
Profile view of a young adult with oral lymphangioma (same patient as in Media File 2).
Superficial lymphatic malformation.
Superficial lymphatic malformation.
 
 
 
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