Presentation
Status post total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) with lymph node dissection. Presented with a cystic pelvic lesion on postoperative ultrasound, warranting further assessment.
Patient Data
Right pelvic well-defined cystic lesion along the course of the right external illiac vessels. The content shows fluid signal with low T1W and high T2W signal. The lesion appears well-defined with no evidence of contrast uptake on contrast-enhanced sequences or restricted diffusion on DWI. Picture is highly suggestive of post operative pelvic lymphocele.
Case Discussion
A lymphocele or lymphocelic cyst is a collection of lymphatic fluid in a cavity usually lined with fibromembranous tissue. Lymphatic fluid collections develop in up to 40% of pelvic operations. Ultrasound is usually the initial modality for assessment of a pelvic collection; however, CT is used for restaging and postoperative assessment, while MRI is used for characterization.
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