Activating p.Q61R mutation in NRAS, another member of RAS family upstream of PI3K/AKT/MYC and MEK pathways, was found in a patient diagnosed with generalised lymphatic anomaly and multiple patients diagnosed with Kaposiform lymphangiomatosis (KLA), an aggressive subtype of GLA [27,28,152]. This evidence concerns the gene AKT1 and diffuse lymphatic malformation.