Focal aggregates of lymphocytes could be seen in the walls of the channels and in the parenchyma adjacent to the lesion. Some channels were filled with red blood cells; others contained eosinophilic fluid. The surrounding pulmonary tissue was the site of a mild peribronchiolar lymphocytic infiltration. Acute intra-alveoalar hemorrhage was prominent in a few areas.
Discussion
Diffuse or localized dvsplastic development and increased intralymphatic pressure are essentially the two pathogenetic mechanisms traditionally invoked to explain the presence of lymphatic anomalies in children. review
In the case of this patient, it is not possible to categorically establish the pathogenetic mechanism involved in the development of the pulmonary lesion. Its first detection at eight years of age and gradual enlargement on sequential chest roentgenograms is not necessarily an indication in favor of or against the diagnosis of lymphatic hamartoma (lymphangioma). It is well established that vascular hamartomas may be inconspicuous at birth. They enlarge through opening of collapsed channels, in addition to their natural growth which is coordinated with that of the rest of the body.