Orbital lymphangioma

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Orbital lymphangioma

  1. 1. ORBITAL LYMPHANGIOMA<br />37 yr old male Patient sudeen onset proptosis in the Rt eye with associated Redness x 12 days.<br />MERCURY IMAGING INSTITUTE <br />SCO 172-173 SEC 9C CHANDIGARH<br />MERCURY IMAGING CENTRE <br />SCO 16-17 SEC 20D CHANDIGARH<br />
  2. 2. PRESENT CASE<br />Large macrolobulatedintraconal / extraconal mass In the RtRetroorbitalregion with following features :<br />Fluid signal levels with acute / subacute stage haemorrhage<br />Minimal post contrast enhancement <br />Sudden onset proptosis .<br />
  3. 3. Some facts ................................<br />Lymphangioma is a benign vascular tumour<br />which is probably congenital, slowly growing<br />and may not become clinically apparent for<br />months and for years.Thetumour may affect<br />the conjunctiva, the lids and the orbit. Associated<br />similar extraorbital lesions include facial<br />and palatal cystic lesions. Intracranial vascular<br />anomalies have been reported to be associated with the lesion.<br />
  4. 4. Intraconal / extra conal mass with macrolobulation is appreciated in the Rt orbit. Multiple fluid signal levels are appreciated . Supernatant and subnatant signal corroborates with acute / subacute stage haemorrhage.<br />
  5. 5. POST CONTRAST ENHANCEMENT IS MINIMAL – SUPPORTS LYMPHANGIOMA AS POSSBILITY <br />
  6. 6. FLUID LEVELS IN MULTIPLE PLANES<br />Differentiate haemorrhagic cysts from the lymphangitic cysts .<br />( Haemorrhagic cysts have variable signal as per stage)<br />( Lymphatic cysts have hypointense signal on T1 and hyperintense signal on T2 )<br />
  7. 7. GRADIENT SEQUENCE DONE TO ASSESS BLOOM IN THE FLUID SIGNAL LEVELS - Rules out chronic haemorrhage<br />
  8. 8. LOBULATED CONTOUR WITH MASS EFFECT ON THE ADJACENT MUSCLE COMPARTMENTS .<br />
  9. 9. PYRAMIDAL SHAPE OF THE LESION WITH BASE TOWRADS THE GLOBE<br />
  10. 10. Lesson learnt........................<br />MR angiogram of the brain should be combined with Routine imaging of the orbital lesion to assess the connection of the orbital lesion with intracranial arterial / venous channels. <br />Another terminology used for such kind of lesions is combined venous lymphatic -vascular malformations.<br />Types of lymphangioma – Orbital , Superficial , Combined, <br />Superficial lymphangioma – Preseptal compartment.<br />Orbital lymphangioma – Post septal compartment. ( Both intraconal / extra conal components ).<br />Combined lymphangioma – Both preseptal and post septal compartments. <br />

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