Enlarged cisterna chyli

Case contributed by James Harvey
Diagnosis almost certain

Presentation

Patient presented to his GP with 10kg unintentional weight loss. No abdominal pain or localizing symptoms.

Patient Data

Age: 50-60
Gender: Male

CT abdomen and pelvis

ct

A rounded, fluid-density (~20HU) retrocrural structure is located between the aorta and IVC. It measures 24 x 30 mm. The structure displaces both vessels however fat planes are preserved. There is no solid component or internal complexity and the lesion has a benign apperance.

MRI abdomen

mri

The saccular structure follows fluid signal on all sequences, demonstrating homogeneous T1 hypointensity and T2 hyperintensity. It is continuous with a left lumbar lymphatic trunk and continues superiorly as the thoracic duct.

Case Discussion

The cisterna chyli is formed as the confluence of the lumbar and intra-abdominal lymphatic trunks. It is positioned immediately to the right of the aorta at the L1/2 level.
In one study, average size was measured at 12.9mm (range = 11 to 19 mm).1

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