Soft tissue tumors
Cystic / cavernous lymphangioma (cystic hygroma)

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 30 September 2016, last major update November 2012

Copyright: (c) 2003-2016,, Inc.

PubMed Search: cystic [title] OR cavernous [title] lymphangioma, "cystic hygroma"
Cite this page: Cystic / cavernous lymphangioma (cystic hygroma). website. Accessed October 28th, 2016.
Definition / General
  • Large, irregular vascular spaces (similar to cavernous hemangioma, may resemble cysts) lined by flattened, bland epithelial cells
  • Cystic and cavernous lymphangiomas are usually considered the same entity (eMedicine)
Clinical Features
  • In children, usually in neck or axilla; may extend into mediastinum
  • Large mediastinal lesions may compress lungs, heart and nerves, but most lesions are asymptomatic and found on x-ray
  • Rarely occur in lymph nodes (Am J Surg Pathol 1992;16:335)
Case Reports
  • Complete surgical excision is recommended to prevent recurrence
  • May cause fetal death due to hydrops
  • Intrauterine sclerosing agents may reduce respiratory and feeding problems associated with fetal neck tumors (Fetal Diagn Ther 2009;26:102)
  • Rarely may spontaneously regress
Clinical Images
Images hosted on other servers:

Omentum: 30 cm tumor in 4 year old girl

Scrotal tumor with hemorrhage in 3 year old boy

Abdominal cyst: 25 cm

Broad ligament: 19 kg tumor in 70 year old woman

Mesentery: 1 year old boy

Thigh tumor

Mesenteric tumor: 12 year old girl

Mesenteric tumors

Gross Description
  • May be massive
  • Gray white, edematous appearing
  • Variable sized cystic cavities with serous type fluid and smooth inner lining
Micro Description
  • Large, irregular vascular spaces lined by flattened, bland epithelial cells with fibroblastic or collagenous stroma
  • Stroma may contain lymphocytes
  • Abdominal tumors may have marked inflammatory changes that obscure their lymphatic origin (Hum Pathol 2005;36:426)
  • Rarely has papillary endothelial proliferation (Arch Pathol Lab Med 1979;103:306)
  • No specialized epithelium, no cholesterol granulomas
  • Not encapsulated, so removal can be difficult
Micro Images
Images hosted on PathOut server:

Case of the Week #377:

AFIP Third Series:

Orbital tumor has large dilated lymphatics, some with blood

Numerous lymphatics,
some with blood;
lymphocytes between

Images hosted on other servers:



Abdominal mass

Mesenteric tumor

Adrenal gland: H&E and CD31

Broad ligament: H&E and D2-40

Breast tumor

Molecular / Cytogenetics Description

Neck tumor