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A digital manual for the early diagnosis of oral neoplasia

Lymphangioma  Search in Medline for Lymphangioma

Lymphangioma is a benign hamartomatous lesion of the lymphatic endothelium, usually seen in children under two years. The tongue is the most common site, followed by buccal mucosa. Clinically, they appear as a somewhat circumscribed painless swelling, that is soft and fluctuant on palpation. The lesions vary from small pinhead size to large lesions involving the entire tongue with green and pink irregular nodular surface with a pebbly vesicle-like appearance (frog-spawn appearance). Malignant transformation is extremely rare. The diagnosis is always by biopsy. Small superficial lesions may be observed as some of them regress spontaneously. Symptomatic cases may be managed with laser or with surgical excision. Sclerotherapy is not very effective.

Differential diagnosis:



Figure 1: Lymphangioma of the tongue. Note the exophytic, sessile growth on the right side of the dorsum of tongue in this 24–year-old patient. The diagnosis of lymphangioma was confirmed on excision biopsy.
Figure 2: Lymphangioma dorsum of the tongue. A raised irregular lesion on the posterior aspect of the tongue in this 13–year-old boy. Histopathological examination showed lymphangioma.
Figure 3: Lymphangioma of the tongue. Note the prominent pebbly appearance with a central groove involving the ventral surface of the tongue.
Figure 4: Lymphangioma of the tongue. Note the macroglossia with crenation on left periphery and dorsum of the tongue showing pebbly appearance in the centre and multiple hypertrophied fungiform papillae.
Figure 5: Lymphangioma of the tongue.
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