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From Birth to Growth: Why Are Lymphatic Malformations So Common in Children?
Lymphatic malformations are benign, slow-flowing vascular malformations that primarily affect the lymphatic system, a system involved in fluid circulation and immune response. These malformations are characterized by the failure of the lymphatic vessels to connect properly to the lymphatic circulation. Although the term "lymphoma" has been used in the past to describe these conditions, new research is moving toward using the term "lymphoid malformation" to more accurately reflect their nature. Lymphatic malformations can be large cystic, small cystic, or a combination of both and may occur at any age, but 90% of patients are diagnosed between birth and two years of age, usually affecting the head and neck.
"The high incidence of lymphatic malformations in children has aroused widespread concern in the medical community. Some of these lesions may be related to congenital chromosomal abnormalities."
According to the International Society for the Study of Vascular Malformations classification, many of the old terms are now outdated, which may cause some medical professionals and patients to miss some important information. These malformations, including macrocystic and microcystic lymphatic malformations, are usually detectable during the fetal period on ultrasound and may be associated with a variety of significant symptoms.
Symptoms and signs
There are three types of lymphatic malformations, each with its own unique signs and symptoms. First, primary lymphomas appear as small blisters on the surface of the skin, ranging in color from pink to dark red, very similar to blisters, and this condition usually does not require medical intervention. Secondly, cavernous lymphomas are often seen at birth but may also appear later, usually in areas such as the neck, tongue, and lips. They vary in size and color and are accompanied by mild pain.
"The symptoms of cavernous lymphoma may change over time, and some patients may experience a mild pressure on it."
Causes
The direct cause of lymphatic malformations is blockage of the lymphatic system during fetal development, however the specific cause of this condition remains unknown. Studies have shown that cystic lymphomas, which form in early pregnancy, are associated with genetic diseases such as Noonan syndrome and Down syndrome, reminding us of the importance of genetics in dealing with this health issue.
Diagnosis and classification
Diagnosis of lymphatic malformations is generally based on histopathological examination and can be made prenatally using ultrasound in the early first or second trimester. The classification of lymphatic malformations includes microcystic and macrocystic, which are graded according to the size of the cysts. The classification of these lesions not only helps with diagnosis, but also guides the direction of clinical treatment.
"The grading and characterization of lymphatic malformations will help advance medical treatment and provide more precise treatment plans for patients."
Treatment methods
Surgical excision is usually recommended for cystic lymphomas, but complete removal can sometimes be difficult because the lesions may involve surrounding normal tissue. In addition, for some lesions, the use of non-invasive treatment methods such as chemotherapy drugs or lasers is also a popular option among doctors.
Recent studies have shown that treating lymphatic malformations with sirolimus can reduce symptoms and prevent further growth of the lesions. With the advancement of medical technology, this research based on targeted treatment is expected to bring hope to many families.
"The application of sirolimus has changed the treatment model of lymphatic malformations and demonstrated the progress of modern medicine."
Future Outlook
Although the prognosis of lymphatic malformations is generally good, patients still need to pay attention to potential complications during long-term follow-up. After surgery, patients may face problems such as surgical wound infection, lymph leakage, or secondary lymph node infection. These challenges not only affect patients’ quality of life, but also require concerted efforts from all parties to improve treatment options and patient care.
As our understanding of lymphatic malformations grows, researchers continue to search for their exact causes and best treatments. It’s worth asking: How can we better understand and address these growing health challenges among children?
