Usually, lesions are asymptomatic or do not show any evidence of a disease, but, mostly, patients may have random break outs of some bleeding and major drainage of clear fluid from ruptured vesicles.Cavernous lymphangioma first appears during infancy, when a rubbery nodule with no skin changes becomes obvious in the face, trunk, or extremity. These lesions often grow at a rapid pace, similar to that of raised hemangiomas. No family history of prior lymphangiomas is described.Cystic hygroma causes deep subcutaneous cystic swelling, usually in the axilla, base of the neck, or groin, and is typically noticed soon after birth. If the lesions are drained, they will rapidly fill back up with fluid. The lesions will grow and increase to a larger size if they are not completely removed in surgery. Diagnosis
Cases of lymphangioma are diagnosed by histopathologic inspection. In prenatal cases, lymphangioma is diagnosed during the late first trimester or early second trimester using an ultrasound. Other imaging methods such as CT and MRI scans are useful in treatment planning, delineate the size of the lesion, and determine its surrounding vital structures. T2-weight MRI is useful to differentiate lymphangioma from surrounding structures due to its high T2 signal. Classification
Lymphangiomas have traditionally been classified into three subtypes: capillary and cavernous lymphangiomas and cystic hygroma. This classification is based on their microscopic characteristics. A fourth subtype, the hemangiolymphangioma is also recognized. Capillary lymphangiomas
Capillary lymphangiomas are composed of small, capillary-sized lymphatic vessels and are characteristically located in the epidermis.
Bacterial enteropathogens cause about 80% of cases. Viruses and protozoans account for most of the rest.The most common causative agent isolated in countries surveyed has been enterotoxigenic Escherichia coli (ETEC). Enteroaggregative E. coli is increasingly recognized. Shigella spp. and Salmonella spp. are other common bacterial pathogens. Campylobacter, Yersinia, Aeromonas, and Plesiomonas spp. are less frequently found. Mechanisms of action vary: some bacteria release toxins which bind to the intestinal wall and cause diarrhea; others damage the intestines themselves by their direct presence.Brachyspira pilosicoli pathogen also appears to be responsible for many chronic intermittent watery diarrhea and is only diagnosed through colonic biopsies and microscopic discovery of a false brush border  on H&E or Warthin silver stain: its brush-border is stronger and longer that Brachyspira aalborgis brush-border. It is unfortunately often not diagnosed as coproculture does not allow growth and 16S PCR panel primers do not match Brachyspira sequences.While viruses are associated with less than 20% of adult cases of travelers diarrhea, they may be responsible for nearly 70% of cases in infants and children. Diarrhea due to viral agents is unaffected by antibiotic therapy, but is usually self-limited. Protozoans such as Giardia lamblia, Cryptosporidium and Cyclospora cayetanensis can also cause diarrhea. Pathogens commonly implicated in travelers diarrhea appear in the table in this section.A subtype of travelers diarrhea afflicting hikers and campers, sometimes known as wilderness diarrhea, may have a somewhat different frequency of distribution of pathogens. Risk factors
The primary source of infection is ingestion of fecally contaminated food or water.