Case Reports

Unusual findings of contrast study in a cervicomediastinal cystic hygroma : A case report

Takehito Oshio, Hiroki Ishibashi, Tomoko Sogami, Shuichi Takano
Department of Surgery, National Kagawa Children’s Hospital

Abstract

　　A one-year-old boy was referred to our institution because of a swelling during the expiratory phase, and depression during the inspiratory phase on the right lower cervix. He did not complain of any symptoms. He was diagnosed as having a cervicomediastinal cystic hygroma, a dumbbell-shaped mass, by findings of MRI studies. His family refused both sclerotherapy and operation. Contrast study was performed to clarify the location and connection of the cysts. During each respiration, contrast material containing lymphatic fluid moved with a to-and-fro motion. The changes in swelling and depression on the neck were the result of changes in the shape of the cystic mass due to the intrathoracic pressure. At two years of age, severe swelling in his right cervix developed. This was due to infection and hemorrhage of the lymphangioma. Antibiotic administration and aspirations of the lymphangioma, a contrast study was repeated. The large cervicomediastinal mass maintained a fixed form with pressure of 40cm H2O, and was not influenced by breathing motions.
The reason for the difference in the findings of each contrast study is thought to be that in the first study, the inside pressure of the lymphangioma was low, while in the second, the pressure was much higher than the intrathoracic pressure.

Keywords：Contrast study, Lymphangioma, Dumbbell, Respiration, Child