#Lymphangiectasis# is a dilated or varicose condition of lymph vessels.  It is met with as a congenital affection in the tongue and lips, or it may be acquired as the result of any condition which is attended with extensive obliteration or blocking of the main lymph trunks.  An interesting type of lymphangiectasis is that which results from the presence of the filaria Bancrofti in the vessels, and is observed chiefly in the groin, spermatic cord, and scrotum of persons who have lived in the tropics.

Filarial disease in the lymphatics of the groin appears as a soft, doughy swelling, varying in size from a walnut to a cocoa-nut; it may partly disappear on pressure and when the patient lies down.

The patient gives a history of feverish attacks of the nature of lymphangitis during which the swelling becomes painful and tender.  These attacks may show a remarkable periodicity, and each may be followed by an increase in the size of the swelling, which may extend along the inguinal canal into the abdomen, or down the spermatic cord into the scrotum.  On dissection, the swelling is found to be made up of dilated, tortuous, and thickened lymph vessels in which the parent worm is sometimes found, and of greatly enlarged lymph glands which have undergone fibrosis, with giant-cell formation and eosinophile aggregations.  The fluid in the dilated vessels is either clear or turbid, in the latter case resembling chyle.  The affection is frequently bilateral, and may be associated with lymph scrotum, with elephantiasis, and with chyluria.

The diagnosis is to be made from such other swellings in the groin as hernia, lipoma, or cystic pouching of the great saphenous vein.  It is confirmed by finding the recently dead or dying worms in the inflamed lymph glands.

Treatment.—­When the disease is limited to the groin or scrotum, excision may bring about a permanent cure, but it may result in the formation of lymphatic sinuses and only afford temporary relief.

#Lymphangioma.#—­A lymphangioma is a swelling composed of a series of cavities and channels filled with lymph and freely communicating with one another.  The cavities result either from the new formation of lymph spaces or vessels, or from the dilatation of those which already exist; their walls are composed of fibro-areolar tissue lined by endothelium and strengthened by non-striped muscle.  They are rarely provided with a definite capsule, and frequently send prolongations of their substance between and into muscles and other structures in their vicinity.  They are of congenital origin and usually make their appearance at or shortly after birth.  When the tumour is made up of a meshwork of caverns and channels, it is called a cavernous lymphangioma; when it is composed of one or more cysts, it is called a cystic lymphangioma.  It is probable that the cysts are derived from the caverns by breaking down and absorption of the intervening septa, as transition forms between the cavernous and cystic varieties are sometimes met with.