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March 1980

Radiological Case of the Month

Author Affiliations

From the Departments of Radiology (Drs Haimovici and LaVigne) and Obstetrics and Gynecology (Dr Howard), Medical Associates, Chelmsford, Mass.

Am J Dis Child. 1980;134(3):311-312. doi:10.1001/archpedi.1980.02130150065017

A 34-year-old woman was sent for ultrasound examination "because [of] a disproportionally large uterus for the dates." Physical examination and previous medical history were unremarkable. Her obstetrical history was two normal pregnancies from a first marriage and from a second marriage, a spontaneous abortion and a stillborn baby at 25 weeks with harelip, cleft palate, and low-set ears. The ultrasound examination (Fig 1) shows a fetus of approximately 28 weeks' gestation, with a large mass around the head and the neck. Three weeks after the ultrasound examination, fetal death occurred and a cesarean section was performed.

Denouement and Discussion 

Hygroma (Cystic Lymphangioma): Diagnosis by Ultrasound  Hygroma's are congenitally modified lymphatics presenting as a large single cavity or as multilocular fluid cavities. Most often they develop on one side of the neck, but may be found in other locations. The cysts, filled with clear straw-colored fluid, are lined by a single layer of flat endothelial cells and surrounded by connective