title: Ultrasonic findings of fetal axillary lymphangioma with intralesional hemorrhage.
abstract: We report a case of an axillary lymphangioma in a fetus delivered at 30 weeks' gestation with suspected intralesional hemorrhage based on the ultrasonic findings. In the ultrasonic examination at 15 weeks' gestation, the fetus was found to have a multilocular mass spreading from the axilla to the chest wall, which was diagnosed as an axillary lymphangioma. Chromosome analysis by amniocentesis showed a normal karyotype, and no other malformations were observed. At 29 weeks, the mass had increased in size, and color Doppler ultrasound examination revealed that the middle cerebral artery peak systolic velocity (MCA-PSV) reached 80.2 cm/s [1.86 MoM (multiples of the median)]. Intralesional bleeding was suspected because of the multiple images of hemorrhage in which sites of blood spouting in a pulsatile fashion were detected within the mass. Cordocentesis at 30 weeks revealed that fetal hemoglobin concentration was 5.1 g/dL. An emergency Cesarean section was performed. A female weighing 2810 g, including the mass, was delivered, and the blood hemoglobin level was 5.9 g/dL at birth. Blood transfusion, fine-needle aspiration of the fluid in the mass, intralesional injection of OK-432, and partial excision of the lymphangioma were performed after birth. Ultrasonic examination proved useful in the diagnosis of intralesional bleeding in this lymphangioma.
authors.affiliation: Department of Obstetrics and Gynecology, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Furue
authors.affiliation: Department of Obstetrics and Gynecology, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan. motizuki@med.kitasato-u.ac.jp.
authors.forename: Junko
authors.initials: J
authors.lastname: Mochizuki
authors.affiliation: Department of Obstetrics and Gynecology, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Department of Obstetrics and Gynecology, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Kawano
authors.affiliation: Department of Obstetrics and Gynecology, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanai
authors.affiliation: Department of Pediatrics, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, Sagamihara, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kemmochi
authors.affiliation: Department of Pediatric Surgery, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, Sagamihara, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Obstetrics and Gynecology, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Unno
mesh_terms: D000328:Adult; D001365:Axilla / Q000000981:diagnostic imaging / Q000196:embryology / Q000473:pathology; D002585:Cesarean Section; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000196:embryology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D008202:Lymphangioma / Q000000981:diagnostic imaging* / Q000196:embryology / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging* / Q000196:embryology / Q000473:pathology / Q000628:therapy; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal
keywords: Axillary lymphangioma; Fetus; Prenatal diagnosis; Ultrasonography