PEDIATRICS Section 3: Head and Neck (Misc Veno/Lymphatics) Flashcards
What do lymphatic and venous malformation look like?
Large strans-spatial multicystic mass in the neck.
Both can have fluid levels
How do you tell lymphatic and venous malformations apart?
Venous Malformations - ?
Lymphatic Malformations - ?
Phleboliths suggests what?
Can they coexist together?
Venous Malformations - Enhancement of the cystic spaces
Lymphatic Malformations - enhancement of the septa
Phleboliths suggests what? - Venous
YES!! they can coexist
These things are actually the most common congenital lesions in the head and neck
Hemangioma of Infancy
Hemangioma of Infancy, Things to know!
How they look?
Phases?
Indications for treatment?
Treatment?
Associations?
How they look = Super T2 bright, with a bunch of
flow voids. Diffusely vascular on doppler.
Phases = Typically they show up around 6 months of
age, grow for a bit, then plateau, then involute (6-10
years). Usually they require no treatment.
Indications for Treatment = Large size / Rapid growth
with mass effect on the airway or adjacent vascular structures. Fucking with the kids eye movement or eyelid opening.
Treatment = Typically medical = Beta blocker (propranolol)
Associations = PHACES Syndrome - think this if it is intra-cranial or muhiple
what is the difference between infantaile hemangioma vs Congenital hemangiomas?
Infantile Hemangiomas = NOT present at birth. Show up around 6 months of age. Nearly always involute.
Congenital Hemangiomas =
Present at birth. May (RICH) or may not (NICH) involute.
Cystic mass hanging at the back of the neck on OB US (posterior triangle on CT/MRI)
Cystic Hygroma (Lymphangioma)
Associated conditions on Cystic Hygroma
Turners (MOST COMMON)
Downs (2nd MOST COMMON)
Coarctation of the Aorta (Common CV abnormality)
Fetal Hydrops (poor prog)
Septation (Worse Out come)
Cystic Hygroma vs Hemangioma
T2 Bright
Does NOT enhance. (hemangiomas typically do)
Diagnosis?
Cystic Hygroma (Lymphangioma)
Cant TURNer its head ;P
Diagnosis? Describe
Fibromatosis Coli (“Congenital Torticolis”)
Ultrasound can look scary, until you realize it’s just the enlarged SCM.
4 week old with a palpable neck mass and torticollis TOWARD the affected side.
Best imaging?
Fibromatosis Coli (“Congenital Torticolis”)
Ultrasound
Most common cause of a neck “mass” in infancy
Fibromatosis Coli
Fibromatosis Coli vs Neuroblastoma
Things that make you think it’s not FC:
mass is outside the SCM, or internal calcifications
- in which case you should think to yourself… nice try Mother fuckers- that’s a NEUROBLASTOMA.
most common mass in the masticator space of a kid (~ 70 % occur before age 12)
Rhabdomyosarcoma
If you see Rhabdomyosarcoma, its always in what part of the head?
Orbit
