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THROUGH THE LENS
Year : 2016  |  Volume : 7  |  Issue : 1  |  Page : 68-69  

Lymphangioma circumscriptum of the male genitalia


Department of Dermatology, L. T. M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India

Date of Web Publication18-Jan-2016

Correspondence Address:
Ganesh Avhad
Room No. 304, New RMO Hostel, L. T. M. Medical College and General Hospital, Sion, Mumbai - 400 022, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.174311

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How to cite this article:
Avhad G, Jerajani H. Lymphangioma circumscriptum of the male genitalia. Indian Dermatol Online J 2016;7:68-9

How to cite this URL:
Avhad G, Jerajani H. Lymphangioma circumscriptum of the male genitalia. Indian Dermatol Online J [serial online] 2016 [cited 2019 Mar 23];7:68-9. Available from: http://www.idoj.in/text.asp?2016/7/1/68/174311

A 52-year-old male presented with clear fluid-filled lesions with discharge over the penis and scrotum since last 8 years [Figure 1]. There was no history of similar lesions in the family, any sexually transmitted disease, or surgical procedure performed on scrotum in the past. Routine hemogram was normal with normal eosinophil count. Ultrasonography of skin showed multiple tiny cysts in the upper papillary dermis without any subcutaneous component. Histopathology showed atropic epidermis with elongated rete ridges and multiple dilated lymphatic channels lined by single layer lining with lymphocytic infiltrate [Figure 2].
Figure 1: Multiple tiny skin-colored to translucent vesicles and papules over scrotum and penis

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Figure 2:Grouped cystic lymphatic spaces present in the upper dermis lined with single layer lining with lymphocytic infiltrate (H and E, ×40)

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Hence, on the basis of clinicohistopathological correlation, diagnosis of lymphangioma circumscriptum (LC) was made.

LC is congenital or acquired hamartomatous lymphatic malformation of the skin. It is the most common type of cutaneous lymphangioma; the other types are cystic hygroma, lymphangio-endothelioma, and cavernous lymphangioma. It is characterized by multiple translucent vesicles of different sizes, which contain clear lymph fluid, but it may become hemorrhagic. It may become grouped with verrucous changes which sometimes give warty appearance of the lesion. It can occur anywhere over the body, but commonly occurs over proximal extremity, shoulder, and neck. Involvement of genital is very rare. LC has superficial dermal and the deeper subcutaneous cisternal component.[1]

The pathogenesis of LC was first described by Whimster [2] in 1976 which states that LC arises from the collection of subcutaneous lymphatic cisterns which receive lymph from the surrounding tissue but fails to drain into the normal lymphatic system, as they are not connected to them; however, they are connected with the superficial lymph vessels. LC usually remains asymptomatic, but may be complicated by secondary bacterial infections and frequent discharge.

Definitive treatment is necessary for the improvement of cosmetic appearance and to prevent the complication of LC. Various treatment modalities are available such as radiofrequency ablation, sclerotherapy, ablative lasers, and surgical excision of both the superficial as well as deep components to prevent recurrence of lesion which is the most common postoperative complication with recurrence rate up to 25–50% in the 1st 3 months.[1],[3]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Haroon S, Hasan SH. Lymphangioma circumscriptum in the scrotum: a case report. J Med Case Rep 2012;6:233.  Back to cited text no. 1
    
2.
Whimster IW. The pathology of lymphangioma circumscriptum. Br J Dermatol 1976;94:473-86.  Back to cited text no. 2
[PUBMED]    
3.
Pal DK, Banerjee M, Moulik D, Biswas BK, Choudhury MK. Lymphangioma circumscriptum of the scrotum following vasectomy. Indian J Urol 2010;26:294-5.  Back to cited text no. 3
[PUBMED]  Medknow Journal  


    Figures

  [Figure 1], [Figure 2]



 

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