Lymphatic malformations

A lymphatic malformation is an abnormality of the lymphatic system. This information sheet is about lymphatic malformations, what causes them and how they can be treated. It also outlines what you can expect when your child comes to Great Ormond Street Hospital (GOSH) for assessment and treatment.

The lymphatic system forms part of the immune system that identifies and fights off invaders, such as bacteria and viruses consisting of a network of vessels within the body through which lymph circulates, and many lymph nodes which filter the lymph fluid and help the body fight infection.

A lymphatic malformation may appear as a lump just under the skin anywhere in the body. Superficial lymphatic malformations can look like small bubbles under the skin. Some lymphatic malformations are not visible on the surface of the body.

Diagnostic tests such as scans may be required to confirm the diagnosis and also to understand the extent of the lymphatic malformation.

A lymphatic malformation occurs when the lymph vessels fail to form correctly during the first few weeks of pregnancy.

No, as they occur so early in pregnancy, they cannot be prevented. However, the effects of the lymphatic malformation can be reduced or prevented. Lymphatic malformations may swell and become tender or painful when the body is fighting an infection. Infections should be identified and treated promptly.

Lymphatic malformations may require treatment if they are likely to interfere with function, for example, with breathing or feeding.

If a child develops infections within the malformation frequently and they are not controlled by antibiotics, other options for treatment using sclerotherapy or surgery may be considered.

There are two main options for treatment: sclerotherapy and surgical removal.

This is a procedure carried out by an interventional radiologist, who shrinks the lymphatic vessels by injecting a special substance through the skin under general anaesthetic. It may require several sclerotherapy sessions and even then, it might grow again.

Sometimes, lymphatic malformations can be removed safely. Detailed scans will be needed to plan the operation. There will be a certain amount of scarring after the operation, as with all surgery.

Like the options available for treatment, this depends on the size and location of the malformation. Many children who have been treated at GOSH are now leading fulfilling lives, attending college and working. Some young people require ongoing care so will need to transfer to adult services between the ages of 16 and 18 years.