Thoracic duct cysts: A rare differential diagnosis

2005 ◽  
Vol 132 (2) ◽  
pp. 330-333 ◽  
Author(s):  
Frank Gottwald ◽  
Heinrich Iro ◽  
Carsten Finke ◽  
Johannes Zenk
Keyword(s):  
Differential Diagnosis ◽  
Thoracic Duct ◽  
Jugular Vein ◽  
Primary Diagnosis ◽  
Imaging Method ◽  
Left Internal Jugular Vein ◽  
Duct Cyst ◽  
X Ray ◽  
Adjacent Structures ◽  
Rare Differential Diagnosis

OBJECTIVE: Cysts of the thoracic duct located in the supraclavicular region are uncommon. To date only 12 cases in this topographic area have been described in the literature. Between 1998 and 2002, 5 patients presented to our department with the primary symptom of a palpable soft left-supracavicular swelling that could be displaced relative to adjacent structures. SETTING: In each case, sonography showed a hypoechogenic, almost echo-free, distinctly outlined polycyclic structure with distal echo enhancement at the junction of the left internal jugular vein and the subclavian vein. All 5 patients underwent surgery, the cysts were extirpated, and the numerous communicating lymph vessels localized and meticulously ligated. Pathohistologic analysis of the milky, yellowish fluid obtained by intraoperative puncture confirmed the initial suspicion of a thoracic duct cyst in all patients. CONCLUSION: In the case of left supraclavicular masses, the rare differential diagnosis of a thoracic duct cyst must be considered as a possibility. Sonography as the imaging method of choice is sufficient for primary diagnosis. In addition, a thorax x-ray should be performed in order to exclude an intrathoracic involvement. Surgical extirpation marks the therapy of choice in treating such cysts.

Spontaneous thoracic duct cyst presenting as a left supraclavicular mass – report of a case and review of literature

2009 ◽  
Vol 24 (2) ◽  
pp. 82-84 ◽  
Author(s):  
Yan An Wang ◽  
Zhi Yuan Zhang ◽  
Jia Wei Zheng ◽  
Wei Min Ye ◽  
Li Zhen Wang ◽  
...  
Keyword(s):  
Chemical Analysis ◽  
Fine Needle Aspiration ◽  
Thoracic Duct ◽  
Needle Aspiration ◽  
Management Options ◽  
Duct Cyst ◽  
Fine Needle ◽  
Duct Ligation ◽  
Supraclavicular Fossa ◽  
Rare Differential Diagnosis

Spontaneous and asymptomatic supraclavicular thoracic duct cysts occurring in the neck are the rarest. We report a case of a huge thoracic duct cyst occurring in the supraclavicular fossa with a review of the literature and management options. A 28-year-old female had a left supraclavicular mass with a 10-year history. A cervical thoracic duct cyst was diagnosed after chemical analysis of the milky fluid obtained by preoperative fine-needle aspiration. Treatment was achieved by surgical excision of the cyst and thoracic duct ligation. Pathological analysis of the cyst after excision confirmed the diagnosis. In the case of left supraclavicular masses, the rare differential diagnosis of thoracic duct cysts must be considered as a possibility. Magnetic resonance imaging as the imaging method of choice and chemical analysis of the milky fluid obtained by preoperative fine-needle aspiration are sufficient for primary diagnosis. The treatment of this disease consists of simple excision.

scholarly journals Biometric measurements involving the terminal portion of the thoracic duct on left level IV: an anatomic study

2015 ◽  
Vol 94 (1) ◽  
pp. 1
Author(s):  
Andressa Cristina Sposato Louzada ◽  
Soo Jin Lim ◽  
Alvaro Masahiro Yoshio ◽  
Vergilius José Furtado Araújo-Neto ◽  
Cesar Augusto Simões ◽  
...  
Keyword(s):  
Thoracic Duct ◽  
Jugular Vein ◽  
Brachiocephalic Vein ◽  
Left Internal Jugular Vein ◽  
Terminal Portion ◽  
Anatomic Study ◽  
Left Brachiocephalic Vein ◽  
Final Segment ◽  
Biometric Measurements ◽  
Omohyoid Muscle

<p>BACKGROUND: During a neck dissection involving the left IV level, the final segment of the thoracic duct (TD) may be injured, significantly increasing postoperative morbi-mortality. The best treatment is its prevention. However, there is a lack of helpful biometric measurements focusing on the TD termination in the literature. MATERIALS AND METHODS: The TD termination was identified and some helpful biometric measurements were obtained on 25 non-preserved cadavers. Statistical analysis was performed to analyze correlations. RESULTS: TD termination was found on the jugulo-subclavian junction (JSJ - 60%), on the left internal jugular vein (LIJV - 36%), and on the left brachiocephalic vein in 4%. A statistically significant association was found between TD termination on the JSJ and the distance between LIJV and omohyoid muscle (Measurement #1). Individuals with TD termination on the JSJ had median Measurement #1 of 34.5±12.0mm, compared with median Measurement #1 of 22.3±8.7mm among individuals with TD termination on LIJV (p=0.015 – Student´s t-test). The logistic regression showed for every 10mm increment of Measurement #1 there was 1.12x chance to find the TD termination on the JSJ (OR=1.12; CI95%:1,01-1,25; p=0.032). A 19mm cut-off was established for this distance as a diagnostic test to predict the TD termination on the JSJ, with sensitivity of 86.7% (CI95%:59.5-98.3%), specificity of 55.6% (CI95%:21.2-86.3%), PPV of 76.5% (CI95%:50.1-93.2%), NPV of 71.4% (CI95%:25.8-97.2%) and ROC AUC of 79.3% (CI95%: 58.0-92.9%). CONCLUSION: This anatomic study demonstrated the most frequent TD termination was on JSJ and Measurement #1 is able to predict the localization of TD termination.</p>

scholarly journals Thoracic duct cyst of posterior mediastinum: a “challenging” differential diagnosis

2016 ◽  
Vol 4 (9) ◽  
pp. 166-166
Author(s):  
Michalopoulou-Manoloutsiou Electra ◽  
Athanasiou Evangelia ◽  
Bobos Mattheos ◽  
Hatzibougias I. Dimitris ◽  
Paul Zarogoulidis ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thoracic Duct ◽  
Posterior Mediastinum ◽  
Duct Cyst

scholarly journals A clinical case of pulmonary and hepatic echinococcosis

2017 ◽  
Vol 98 (2) ◽  
pp. 261-266
Author(s):  
M L Gorbunova ◽  
S N Volkova ◽  
G V Shestakova ◽  
E L Spiridonova
Keyword(s):  
Differential Diagnosis ◽  
Clinical Case ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Primary Diagnosis ◽  
Diagnostic Methods ◽  
X Ray ◽  
Chest X Ray ◽  
Pulmonary Echinococcosis ◽  
Hepatic Echinococcosis

The article presents а description of our personal case of pulmonary and hepatic echinococcosis in a 38-years-old patient. Literature data on clinical presentation, laboratory and instrumental diagnostic methods of the disease are presented. Different variants of clinical presentation of pulmonary echinococcosis and its possible complications are described. The problems of differential diagnosis, surgical and conventional methods of treatment are analyzed. The presented clinical case confirms the wide spread opinion that the diagnosis of pulmonary echinococcosis based on only the results of chest X-ray is extremely challenging. Frequent diagnostic mistakes are associated with the primary diagnosis of pneumonia based on chest X-ray. Use of high-pitch spiral computed tomography implemented recently into clinical practice provides early differential diagnosis of pulmonary lesions with parasitic diseases, in particular, with echinococcosis. The final diagnosis is confirmed by serologic methods of echinococcosis diagnosis with the use of enzyme immunoassays.

Cervical thoracic duct cyst: a differential diagnosis of left supraclavicular swelling

2007 ◽  
Vol 264 (7) ◽  
pp. 797-799 ◽  
Author(s):  
Lise Moesgaard ◽  
Steen Baerentzen ◽  
Frank Mirz
Keyword(s):  
Differential Diagnosis ◽  
Thoracic Duct ◽  
Duct Cyst

scholarly journals PROBLEMS OF DIFFERENTIAL DIAGNOSIS OF BRONCHIOLOALVEOLAR CARCINOMA

2013 ◽  
Vol 4 (3) ◽  
pp. 61-72
Author(s):  
N Y Urazovsky ◽  
A V Averyanov ◽  
V N Lesnyak
Keyword(s):  
Differential Diagnosis ◽  
Primary Diagnosis ◽  
Bronchioloalveolar Carcinoma ◽  
Distinctive Features ◽  
X Ray ◽  
Modern View

The review presents the modern view on bronchioloalveolar carcinoma. The most attention is paid to the CT as one of the most important methods of primary diagnosis. Authors showed distinctive features of diseases that have similar X-ray picture.

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