Arterial Vascular Malformations Including Hemangiomas and Lymphangiomas Workup

Updated: Mar 16, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Laboratory Studies

The diagnosis of vascular tumors and malformations is usually made solely on the basis of the history and physical examination. No laboratory studies are specifically useful in this setting.


Imaging Studies

Magnetic resonance imaging (MRI) provides precise localization of the lesion. It is performed to detect the presence or absence of associated nervous system abnormalities. Furthermore, because vascular tumors have a distinct appearance on MRI, it is used in the diagnosis of atypical lesions.

Ultrasonography (US) with color flow is cost-effective; however, it is operator-dependent and does not accurately depict the relation of the lesion to other anatomic structures.

Intracranial vascular anomalies are present in more than two thirds of patients with a periorbital lymphatic malformation and potentially require treatment. [44] Imaging of patients with orbital lymphatic malformation should include the brain as well as the orbit.

Antenatal diagnosis of an intracranial, rapidly involuting congenital hemangioma by means of antenatal imaging has been described. [45]

Enhanced noninvasive diagnosis of acquired lymphangiectasias using dermoscopy and reflectance confocal microscopy to demonstrate diagnostic features may avoid the need for a tissue specimen. [46]

Lymphoscintigraphy may be utilized to evaluate potential Klippel-Trenaunay syndrome candidates for thoracic duct decompression if needed. [47]



Biopsy is performed if malignancy is suspected.