Lymphocele of the thoracic duct

Case contributed by Dr Eric F Greif

Presentation

Palpable left supraclavicular mass

Patient Data

Age: 75 years
Gender: Female
CT

CT of the neck

Non-enhancing, tubular/multicystic, multicompartmental, fluid-density structure extending from the left supraclavicular region and inferiorly to the left paraesophageal (posterior mediastinum) region to the level of the aortic arch. The lesion is displacing the sternocleidomastoid muscle/internal jugular vein anteriorly and the trachea/esophagus to the right.

CT

CT of the thorax

Tubular/multicystic, multicompartmental, fluid-density structure extends from the left side of the neck and continues to form several cystic/tubular areas in the posterior mediastinum to the retrocrural region at the expected location of the cisterna chyli.

Annotated image

Dilated thoracic duct entering the left subclavian/brachiocephalic vein (yellow arrow).

Case Discussion

This patient had a long standing soft palpable mass in the left side of the neck. A neck CT with IV contrast was performed and the lesion was believed to be a lymphangioma. Subsequently, a non-contrast chest CT was performed and the tubular/cystic mass extended from the left neck to the posterior mediastinum and to the level of the cisterna chyli, consistent with a lymphocele of the thoracic duct.

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Case information

rID: 53808
Published: 7th Jun 2017
Last edited: 26th Nov 2019
Inclusion in quiz mode: Included

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