{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:14:57Z","timestamp":1784200497700,"version":"3.55.0"},"reference-count":13,"publisher":"Medical Communications Sp. z.o.o.","issue":"105","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Ultrason"],"abstract":"<jats:p>Purpose: To describe the sequential imaging findings and diagnostic utility of ultrasound and contrast-enhanced magnetic resonance imaging in a rare pediatric case of superinfected macrocystic lymphatic malformation of the gluteal region following minor trauma. Materials and methods: A 2-year-old girl with a pre-existing diagnosis of macrocystic lymphatic malformation in the gluteal region presented with acute onset of severe localized pain, fever, and erythema after sustaining blunt trauma. Laboratory tests demonstrated leukocytosis and elevated C-reactive protein, supporting the clinical suspicion of secondary infection. Initial ultrasound evaluation revealed multiple cystic lesions without internal vascularity, accompanied by surrounding soft-tissue edema. Given the concern for secondary infection, a follow-up ultrasound was performed 72 hours later, demonstrating increased vascularity of the cyst walls and internal echogenic debris consistent with superinfection. Subsequently, contrast-enhanced magnetic resonance imaging confirmed abscess formation, characterized by peripheral contrast enhancement, restricted diffusion, and extensive inflammatory changes in the surrounding soft tissues. Results: Integration of sequential imaging findings enabled early and accurate diagnosis of abscess formation within the macrocystic lymphatic malformation. This facilitated prompt initiation of targeted conservative treatment, including intravenous antibiotics and image-guided percutaneous drainage, effectively avoiding emergency surgical intervention and its potential complications. Conclusion: In pediatric patients with macrocystic lymphatic malformations, minor trauma may precipitate secondary infection and abscess development. A stepwise imaging strategy, beginning with ultrasound and supplemented by contrast-enhanced magnetic resonance imaging, is critical for early detection, precise lesion characterization, and guidance of appropriate management to minimize morbidity and improve clinical outcomes.<\/jats:p>","DOI":"10.15557\/jou.2026.0017","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:34:39Z","timestamp":1784198079000},"source":"Crossref","is-referenced-by-count":0,"title":["Macrocystic lymphatic malformation of the gluteal region complicated by\u00a0abscess formation: the crucial role of multimodal imaging in pediatric emergency care \u2013 case report and literature review"],"prefix":"10.15557","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5301-6739","authenticated-orcid":false,"given":"Chiara","family":"Locorotondo","sequence":"first","affiliation":[{"name":"Radiology Unit, \u201cA. Perrino\u201d Hospital, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1526-5047","authenticated-orcid":false,"given":"Manuela","family":"Montatore","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4289-3289","authenticated-orcid":false,"given":"Federica","family":"Masino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2412-0990","authenticated-orcid":false,"given":"Roberto","family":"Maresca","sequence":"additional","affiliation":[{"name":"Radiology Unit, \u201cA. Perrino\u201d Hospital, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4511-9302","authenticated-orcid":false,"given":"Andrea","family":"Torrente","sequence":"additional","affiliation":[{"name":"Radiology Unit, \u201cA. Perrino\u201d Hospital, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-8330","authenticated-orcid":false,"given":"Giuseppe","family":"Guglielmi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3820-1902","authenticated-orcid":false,"given":"Eluisa","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"Radiology Unit, \u201cA. Perrino\u201d Hospital, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6250","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"1. Francavilla ML, White CL, Oliveri B, Lee EY, Restrepo R. Intraabdominal lymphatic malformations: pearls and pitfalls of diagnosis and differential diagnoses in pediatric patients. AJR Am J Roentgenol. 2017;208(3):637\u2013649. doi: 10.2214\/ AJR.16.17008.","DOI":"10.2214\/AJR.16.17008"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"2. Poget M, Fresa M, El Ezzi O, Pauchot J, Hecker C, Alafaci C, et al. Lymphatic malformations in children: retrospective review of surgical and interventional management. Pediatr Surg Int. 2022;39(1):36. doi: 10.1007\/s00383-022-05320-x.","DOI":"10.1007\/s00383-022-05320-x"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"3. Ramirez-Suarez KI, Tierradentro-Garcia LO, Stern JA, Kamath BM, Navarro OM. State-of-the-art imaging for lymphatic evaluation in children. Pediatr Radiol. 2023;53(7):1380\u20131390. doi: 10.1007\/s00247-022-05469-6.","DOI":"10.1007\/s00247-022-05469-6"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"4. Goldenberg DC, Vikkula M, Penington A, Blei F, Kool LS, Wassef M, Frieden IJ; ISSVA Vascular Anomalies Classification Group. Updated Classification of Vascular Anomalies. A living document from the International Society for the Study of Vascular Anomalies Classification Group. J Vasc Anom (Phila). 2025;6(2):e113. doi: 10.1097\/JOVA.0000000000000113.","DOI":"10.1097\/JOVA.0000000000000113"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"5. Amodeo I, Cavallaro G, Raffaeli G, Colombo L, Fumagalli M, Cavalli R, et al. Abdominal cystic lymphangioma in a term newborn: A case report and update of new treatments. Medicine (Baltimore). 2017;96(8):e5984. doi: 10.1097\/ MD.0000000000005984.","DOI":"10.1097\/MD.0000000000005984"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"6. Huerta CT, Beres AL, Englum BR, Gonzalez K, Levene T, Wakeman D et al.; American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee. Management and outcomes of pediatric lymphatic malformations: a systematic review from the APSA Outcomes and Evidence-Based Practice Committee. J Pediatr Surg. 2024;59(10):161589. doi: 10.1016\/j.jpedsurg.2024.05.019.","DOI":"10.1016\/j.jpedsurg.2024.05.019"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"7. Colbert SD, Seager L, Haider F, Evans BT, Anand R, Brennan PA. Lymphatic malformations of the head and neck: current concepts in management. Br J Oral Maxillofac Surg. 2013;51(2):98\u2013102. doi: 10.1016\/j.bjoms.2011.12.016.","DOI":"10.1016\/j.bjoms.2011.12.016"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"8. Zamora AK, Barry WE, Nowicki D, Ourshalimian S, Navid F, Miller JM, et al. A multidisciplinary approach to management of abdominal lymphatic malformations. J Pediatr Surg. 2021;56(8):1425\u20131429. doi: 10.1016\/j.jpedsurg.2020.10.007.","DOI":"10.1016\/j.jpedsurg.2020.10.007"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"9. Crivelli L, Millischer AE, Sonigo P, Gr\u00e9vent D, Hanquinet S, Vial Y, Alamo L. Contribution of magnetic resonance imaging to the prenatal diagnosis of common congenital vascular anomalies. Pediatr Radiol. 2021;51(9):1626\u20131636. doi: 10.1007\/s00247-021-05031-w.","DOI":"10.1007\/s00247-021-05031-w"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"10. Kumar Y, Khaleel M, Boothe E, Awdeh H, Wadhwa V, Chhabra A. Role of diffusion weighted imaging in musculoskeletal infections: current perspectives. Eur Radiol. 2017;27(1):414\u2013423. doi: 10.1007\/s00330-016-4372-9.","DOI":"10.1007\/s00330-016-4372-9"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"11. Snyder EJ, Sarma A, Borst AJ, Tekes A. Lymphatic anomalies in children: update on imaging diagnosis, genetics, and treatment. AJR Am J Roentgenol. 2022;218(6):1089\u20131101. doi: 10.2214\/AJR.21.27200.","DOI":"10.2214\/AJR.21.27200"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"12. Elluru RG, Balakrishnan K, Padua HM. Lymphatic malformations: diagnosis and management. Semin Pediatr Surg. 2014;23(4):178\u2013185. doi: 10.1053\/j.sempedsurg.2014.07.002.","DOI":"10.1053\/j.sempedsurg.2014.07.002"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"13. Bezzola T, B\u00fchler L, Chardot C, Morel P. Le traitement chirurgical du lymphangiome kystique abdominal chez l\u2019adulte et chez l\u2019enfant [Surgical therapy of abdominal cystic lymphangioma in adults and children]. J Chir (Paris). 2008;145(3):238\u2013 243. 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