Key points

• Many lesions that were previously designated as ‘lymphangiomas’ are in fact lymphatic malformations, being mostly congenital in nature

• Specific lymphatic endothelium antibodies identify (partial) lymphatic differentiation in a still increasing number of vascular tumours

• Occurrence of blood-filled spaces, haemorrhages or hobnail appearance of endothelium does not rule out the diagnosis of a lymphatic lesion