Suspected Lymphangioma Simplex

[porkila]

Past complaints were-extreme nausea due to reaction of unfamiliar contraceptive (initial onset of symptoms in 2000), lymphatic system breakdown, vessels small and large pressing from under and breaking through epidermal layer, hard white linear tissue (causing disfigurement) sitting directly under the epidermal layer, thickening of the outer skin layers (white and hard), hard white growths in 5 locations with linear tissue extending, one large malformation (round at base with one raised line extending into the cheek, from which linear tissue extends).Areas effected were only face and neck, until 2004 when the arms became effected. Hard tissue also broke through on both sides of the neck and on chest.Nodules are located, 5 in total, across thorax.I had complaints of nausea in small intestines and breathing issues. I was told none of these complaints were possible, and "nothing is going on in my system". In 2001, a Dermatologist diagnosed cystic Acne, which a second dermatologist disagreed with. He did not believe this to be acne, but could not explain my symptoms.A soft-tissue ultrasound (taken 2004)identified I was suffering a vascular condition, with vascular activity originating at the capillary level (increased activity at the centre of the cheeks). It showed thickening of the skin, and capillary activity occupying the subcutaneous fat, but only effecting the outer skin layers. It identified the large malformation on the right side of my face, not to be a cyst, but the tissue within was too small to identify. Linear tissue was shown to be within a proximity to the epidermal layer, which (expert imaging opinion)indicates this linear tissue is more likely to be vessels and connective tissue, rather than scar tissue.The expert informed me the imaging can raise question to Lymphangioma Simplex. He explained that, both the fact that the vascular activity is within the subcutaneous fat, but only effects the skin, combined with linear tissue and it's proximity to the epidermal layer, could raise question to this disease. A biopsy was taken of a "circle" visual in the outer skin layers (unidentifiable by Dermatologists).Only one "circle" was taken, but these cover the entire surface of the face. They developed nuclei in 2004, and a histopathologist spoke to me regarding the biopsy- simply because he was "at odds to explain" what he saw. He identified the biopsy feature to be a single vessel surrounded by an epithelial polyp. He stated that in order to diagnose, the endothelial cells had to line the biopsy. None were found, but he explained the area was scar tissue, and that this can occur in time with Lymphangioma. Are these in any way similar to the outpouchings of Lymphangioma? As Lymphangioma Simplex is commonly diagnosed by imaging and clinical appearance, Can you please tell me if the information in the ultrasound, along with my history, could raise question to this disease? If so, who can diagnose me within Australia? Thanks

[Alan Rockoff, MD]

I must apologize, but nothing in your detailed description reminds me of any condition with which I am familiar.  Neither the clinical findings nor the laboratory values suggest any diagnosis I know about.  I'm afraid I have nothing to contribute, and all I can suggest is that you get an opinion from a dermatologist at an academic medical center.  Be sure to bring along all prior tests and results, so they won't have to be repeated.

Sorry.

Dr. Rockoff

[porkila]

I am dissapointed of course, but understand your response. I do feel that, however I have not recieved a response which warrants a cost of the $20.00 I forwarded. Could you please consider refunding this amount to my credit card, as my medical expenses leave us in hard financial struggles. I appreciate your understanding.

Yours sincerely,

Larissa Tyler.
(could you please notify me of refund)