Cystic Lymphangioma in an Adult-Diagnosis on Cytology

Abstract

A 63-year old lady presented with a large mass in the right side of the chest since 1 year, which was gradually increasing in size. The swelling was associated with pain for the last 6 months. The patient did not give any history of trauma. On examination, the mass was seen extending from the upper outer quadrant of the right breast medially, up to the right axilla laterally. The swelling measured 10 x 10 cms, and was soft, fluctuant, tender, possibly cystic [Figure 1]. Clinically diagnosed as lipoma and radiologically as cystic disease of the breast and abscess, the diagnosis of lymphangioma was rightly suggested by fine needle aspiration cytology and confirmed with histopathology. This case highlights the role of FNAC in the diagnosis of these lesions. Presence of cystic hygroma in adults makes the present case report unique and interesting. Lymphangiomas or cystic hygromas are cystic lesions commonly seen in the soft tissues of the neck, usually in the paediatric age group. Axilla and breast are rare sites, more so in adults. Lymphangioma is a benign lesion, composed of dilated lymphatic channels. 1 They are common paediatric lesions and are thought to represent developmental malformations rather than true neoplasms. 1,2 Lymphangiomas are relatively rare; more so in adults. They can arise anywhere in the body, with a predilection for the head, neck, and axilla. Their occurrence in the breast is particularly rare and few cases have been reported in literature. 3,4 CLINICAL DIAGNOSIS With the above examination findings, differential diagnoses of lipoma or cystic disease of the breast or chest wall were considered.