case_images: PMC3823387_01
case_images: 29-year-old female with swelling on the right side of her tongue diagnosed as lymphangioma circumscriptum. Intra-oral picture frontal view shows pebbly, vesicle-like feature with so-called "frog-egg" or "tapioca-pudding" appearance (black arrow) and medially extends till midline of tongue (white arrows).
case_images: JCIS-3-44-g002.jpg
case_images: PMC3823387_01_JCIS-3-44-g002.jpg
case_images: F1
case_images: On intra-oral inspection, a single, localized, sessile lesion was seen on the right dorsum of the tongue [Figure 1]. Mucosa over the tongue was well-defined reddish in color with a small area of purplish hue seen on the lateral borders of the tongue and had a pebbly surface [Figure 1].
case_images: 29-year-old female with swelling on the right side of her tongue diagnosed as lymphangioma circumscriptum. Intra-oral picture lateral view shows that the lesion laterally extends till the lateral borders of the tongue (black arrows).
case_images: JCIS-3-44-g003.jpg
case_images: PMC3823387_01_JCIS-3-44-g003.jpg
case_images: F2
case_images: The growth measured about 4.5 cm anteroposteriorly, 3.1 cm mesiolaterally and extended 1 mm from the tip of tongue anteriorly and 2 cm in front of sulcus terminalis posteriorly, medially from the midline of the tongue and laterally extended to the lateral borders of the tongue [Figure 2].
case_images: 29-year-old female with swelling on the right side of her tongue diagnosed as lymphangioma circumscriptum. Diascopy test performed by pressing a glass slide (black arrow) on the lesion results in blanching (red arrow) which suggests that lesion could be a vascular lesion.
case_images: JCIS-3-44-g004.jpg
case_images: PMC3823387_01_JCIS-3-44-g004.jpg
case_images: F3
case_images: The diascopy test performed on the lesion showed blanching, which suggested it to be a vascular lesion [Figure 3].
case_images: 29-year-old female with swelling on the right side of her tongue diagnosed as lymphangioma circumscriptum. Soft-tissue ultrasonograph of the tongue demonstrates a well-defined heterogeneous soft tissue mass of 2.3 cm x 3.3 cm x 2.4 cm (yellow arrows) seen on the right half of the tongue suggestive of a soft tissue tumor.
case_images: JCIS-3-44-g005.jpg
case_images: PMC3823387_01_JCIS-3-44-g005.jpg
case_images: F4
case_images: Soft-tissue ultrasonograph of the tongue demonstrated a well-defined heterogeneous soft-tissue mass of 2.3 cm x 3.3 cm x 2.4 cm on the right half of the tongue [Figure 4].
case_images: 29-year-old female with swelling on the right side of her tongue diagnosed as lymphangioma circumscriptum. Color Doppler imaging in longitudinal section through the right side of the tongue and sub mental region shows heterogeneous mass along with dilated arteries (white arrow) and veins (yellow arrow) suggestive of a vascular malformation.
case_images: JCIS-3-44-g006.jpg
case_images: PMC3823387_01_JCIS-3-44-g006.jpg
case_images: F5
case_images: Dilated arteries and veins were seen in the right submental region on color Doppler studies suggesting that it could be a vascular malformation [Figure 5].
case_images: 29-year-old female with swelling on the right side of her tongue diagnosed as lymphangioma circumscriptum. Hematoxylin and eosin stained soft-tissue section under x40 magnification shows elongated rete ridges (white arrow), papillamatosis (yellow arrow), and cavernous spaces filled with lymph represented as eosinophilic stain (black arrow) suggestive of lymphangioma circumscriptum.
case_images: JCIS-3-44-g007.jpg
case_images: PMC3823387_01_JCIS-3-44-g007.jpg
case_images: F6
case_images: Deep muscle layer appeared normal suggestive of "lymphangioma circumscriptus" [Figure 6].