Authors –

Dr. Tanmayi Kulkarni

Co-authors –

Dr. Dhaval K. Thakkar

Dr. V. M. Kulkarni

Institution –

Dr. D. Y. Patil

Medical College,

Pimpri, Pune

Clinical profile:26 years old female patient, primigravida had come with 7 months amenorrhea.

Also, complaints of decreased fetal movements since that morning.

Ultrasound image shows well defined, anechoic,

asymmetric, multiseptate, thin-walled cystic masses

Ultrasound of coronal and sagittal image of fetal head and neck reveals well

defined, anechoic, asymmetric, multiseptate, thin-walled cystic masses

Diagnosis

Cystic Hygroma

Differential Diagnosis

1. Cystic Hygroma

2. Encephalocele

3. Meningomyelocele

4. Teratomas

Cystic Hygroma

• Hygroma- Moist Tumour

• Anomalies of the lymphatic system

• Characterized by single or multiple cysts within the soft tissue.

• Usually bilateral.

• Involves the posterior aspect of neck.

• Contain clear or cloudy fluid.

Prognosis

• Prognosis is poor.

• It depends on the associated Chromosomal anomalies.

• Usually leads to oligohydramnios or fetal demise.

Pathogenesis

• Fetal Lymphatic system develops at around

5th week of gestation

• Failure to establish lymphatic connection

lead to accumulation of the lymphatic fluid.

• Dilatation of the lymphatic sac leads to the

formation of cystic structure

• Usually partitioned by the fibrous bands

corresponding to nuchal ligament.

Associated Anomalies

Chromosomal anomalies

• Turner"s syndrome (45, X0 or mosaic 46, XX/45, X): 45-50% of cases

• Trisomy 21

• Trisomy 18 15 % of cases

• Trisomy 13

• Trisomy 22 mosaicism

• Partial trisomy 11q/22q

• 13q-syndrome

• 18p-syndrome

• balanced translocation t (6q; 12q

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