Cavernous Lymphangioma of the Breast: Case Report with Electron Microscopic and Immunohistochemical Investigations

Abstract

A rare case of cavernous lymphangioma of the breast in a 16-year-old Japanese girl was investigated by light and electron microscopies, and immunohistochemistry. The patient, who had a soft breast tumor measuring 16 x 14 cm, had undergone a tumorectomy two years after she noticed the tumor. Histologically, the tumor was composed of numerous narrow spaces containing amorphous fluid lined with a monolayer of endothelial cells. Abundant collagen fibers and numerous fibroblasts were found beneath the endothelium. Histological findings confirmed a diagnosis of lymphangioma of the breast. Immunohistochemically, the endothelium showed negative immunoreaction for factor VIII-related antigen, but the discontinuous basal lamina was positive for laminin. Ultrastructurally, numerous microfilaments and pinocytotic vesicles were found in the cytoplasm of the endothelial cells, and intermediate junctions were recognized between adjacent cells. In addition, a discontinuous basal lamina was seen beneath the endothelium. Electron microscopic and immunohistochemical investigations are thus useful in confirming a diagnosis of cavernous lymphangioma of the breast.

Cystic lymphangioma of the breast in an 8-year-old boy: Report of a case with a review of the literature

“…5,11,19 Cystic lymphangioma of the breast is an extremely rare fi nding, and to the best of our knowledge only 13 cases have been reported in the English literature (Table 1). [1][2][3][4][5][6][8][9][10][11][12][13]15 To the best of our knowledge, three additional cases in the Korean literature 7,16,17 and one case in the Japanese literature have also been recorded, 14 thus making a total count of only 17 cases. The fi rst case was reported in 1986 by Sieber and Sharkey.…”

“…It is interesting to note that only one (25%) of these pediatric cases was a female patient. 13 All remaining cases were boys aged 6 years or younger ( Table 1). The present case was an 8-year-old boy and the fi fth pediatric case that has been reported so far.…”

“…Examination reveals a well-circumscribed, smooth and cystic, freely mobile, nontender mass situated most often in the upper outer quadrant. [1][2][3][4][5][6][9][10][11][12][13][14] Cystic lymphangioma represents one of the three subtypes of lymphangiomas, the other two being cavernous, and simple or capillary lymphangioma. Capillary lymphangioma is characterized by only dilatation of several capillary-sized lymphatic vessels that are connected to normal lymphatics.…”

“…3 The breast is an extremely rare site for the occurrence of the cystic lymphangioma, and to the best of our knowledge only 17 such cases have been documented in the world literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Only four of these cases have been reported in children. 9,11,13,14 A complete surgical excision is the treatment of choice.…”

Cystic lymphangioma of the breast in a 6-year-old boy

“…They are most often located in the neck region and axilla [3]. The breast is an extremely infrequent site for the occurrence of the cystic subtype of lymphangiomas, with very few cases documented in the literature [1][2][3][4][5][6][7][8][9][10][11][12]. At this infrequent site, most reported cases are noted in adults.…”