PATHOLOGY OF LYMPHANGIOMA CIRCUMSCRIPTUM

A study of [human] lymphangioma circumscriptum was done over a number of years in an attempt to understand its nature and pathogenesis, with a view to improving treatment. The lesion consists of a collection of large muscular-coated lymphatic cisterns, lying deep in the subcutaneous plane and communicating via dilated dermal lymphatics with the superficial vesicles. It seems that these cisterns do not communicate directly, if at all, with the general lymphatic system but represent a sequestered part of it. They were shown by cannulation to pulsate at a slow steady rate producing a rise and fall of pressure within them. The vesicles are probably saccular dilatations of superficial lymphatics, secondary to raised pressure transmitted from the pulsating cisterns beneath. It may be possible to treat these lesions more successfully and with better cosmetic results by excising the subcutaneous cisterns and leaving the overlying skin intact.