QUIZ: No. 7, 13/04/2025

T2 axial

CASE 7

A 48-year-old female presented with complaints of painless swelling on the dorsum of hand for 6 months with mild restriction of movements. No significant medical and surgical history. X-ray, NCCT and CE MRI images are provided. What’s your diagnosis?

ANS – Macrocystic lymphatic malformation 

Findings: Multi-loculated T1 hypointense / T2 PDFS hyperintense cystic lesion noted in the dorsal aspect of middle and ring finger around the proximal phalanx in the subcutaneous plane. Minimal septal enhancement on contrast administration. No arterial feeder / early enhancement. No erosion of underlying bones. Minimal extension onto the palmar aspect of middle finger. No evidence of phleboliths.

Lymphatic malformations are benign lesions of vascular origin that show lymphatic differentiation and are vascular malformations and not vascular tumours (ISSVA classification). Lymphatic malformations may involve more than one compartment. Multilocular cystic masses with internal septa of varying thickness. There is only minimal or no displacement/compression of adjacent structures.