Intraabdominal Lymphatic Malformations: Pearls and Pitfalls of Diagnosis and Differential Diagnoses in Pediatric Patients.

OBJECTIVE: The purpose of this article is to review the practical imaging workup and characteristic imaging appearances of intraabdominal lymphatic malformations (LMs) in the pediatric population with a brief discussion of some common differential diagnoses found in a vascular anomaly clinic. CONCLUSION: LMs are uncommon pediatric lesions. Because of their rarity among LMs overall, a tendency to present later in life than superficial LMs, and often incidental identification, intraabdominal LMs pose a particular diagnostic challenge, and pathologic entities that are more prevalent must be carefully excluded first. Although the diagnosis of most intraabdominal LMs can be reliably based on clear understanding of characteristic imaging findings, histologic correlation may be necessary in some cases.

MRI of Native Knee Cartilage Delamination Injuries.

OBJECTIVE: The purpose of this article is to describe the normal imaging appearance of cartilage and the pathophysiologic findings, imaging appearance, and surgical management of cartilage delamination. CONCLUSION: Delamination injuries of knee cartilage signify surgical lesions that can lead to significant morbidity without treatment. These injuries may present with clinical symptoms identical to those associated with meniscal injury, and arthroscopic identification can be difficult, thereby creating a role for imaging diagnosis. A low sensitivity of imaging identification of delamination injury of the knee is reported in the available literature, although vast improvements in MRI of cartilage have since been introduced.

Low-Flow Vascular Malformation Pitfalls: From Clinical Examination to Practical Imaging Evaluation--Part 1, Lymphatic Malformation Mimickers.

OBJECTIVE: Palpable subcutaneous masses present in various shapes and sizes in the pediatric population and, accordingly, represent a variety of underlying causes. Lymphatic and venous malformations are among the most common pediatric subcutaneous lesions. However, there are congenital and acquired, as well as benign and malignant, soft-tissue masses that can mimic them clinically and at imaging. CONCLUSION: Here, we review the natural history, wide range of clinical presentations, and varied but characteristic imaging appearance of lymphatic malformations that can pose diagnostic difficulties in children. In addition, the clinical and imaging characteristics of some pediatric soft-tissue pathologies that can mimic lymphatic malformations and clues to reach a proper diagnosis are highlighted.

Low-Flow Vascular Malformation Pitfalls: From Clinical Examination to Practical Imaging Evaluation--Part 2, Venous Malformation Mimickers.

OBJECTIVE: The purpose of this article is to review the unusual clinical and radiographic features of venous malformations that can give rise to diagnostic confusion. Entities that can have overlapping clinical and imaging features with venous malformations are also reviewed. CONCLUSION: Venous malformations are congenital endothelial malformations secondary to errors in vascular morphogenesis and are usually diagnosed in the first 2 decades of life. The clinical and imaging features of venous malformations often overlap those of other pathologic entities, creating diagnostic confusion. Furthermore, the clinical presentation and imaging appearance of venous malformations can vary, making the diagnosis challenging. Thorough knowledge of the various clinical and imaging features not only of venous malformations but also of the major potential mimic lesions is crucial for clinicians caring for patients with these lesions.