Abnormal Lymphatic Flow Demonstrated by Lymphoscintigraphy in Chylothorax Correlation With Lymphography

Lymphoscintigraphy may be useful to identify the lymphatic leakage site in some patients with chylothorax. A 60-year-old woman had lung cancer that was complicated by massive chylothorax after radical surgery. Dynamic lymphoscintigraphy after injection of Tc-99m HSA in both feet showed abnormal tracer accumulation in the subcarinal area of the mediastinum after visualizing the lower level of the thoracic duct, indicating a thoracic duct disruption in the inferior mediastinum. Scintigraphic findings were well correlated with lymphographic findings. Subsequent thoracoscopic ligation of the thoracic duct in the inferior mediastinum successfully terminated chyle leakage.