99mTc-Dextran Lymphoscintigraphy SPECT/CT Unveils the Hidden Leakage Site in Recurrent Chylothoraxes

Chylothorax is defined as the accumulation of chyle in the pleural space, mainly by damaging to the thoracic duct. 99mTc-Dextran is a relatively new tracer for lymphoscintigraphy. A 40-year-old woman had recurrent chylothoraxes after thymoma resection and ligation of the thoracic duct owing to intraoperative suspected thoracic duct injury. She underwent lymphoscintigraphies using 99mTc-sulfur colloid and 99mTc-dextran, respectively, to identify the possible leakage site of the thoracic duct. The images showed increased 99mTc-dextran but unimpressive 99mTc-sulfur colloid activity at the leakage site. Based on the results, this patient received surgery anastomosing the thoracic duct and the azygos vein. Chylothorax is defined as the accumulation of chyle in the pleural space, mainly by damaging to the thoracic duct. 99mTc-Dextran is a relatively new tracer for lymphoscintigraphy. A 40-year-old woman had recurrent chylothoraxes after thymoma resection and ligation of the thoracic duct owing to intraoperative suspected thoracic duct injury. She underwent lymphoscintigraphies using 99mTc-sulfur colloid and 99mTc-dextran, respectively, to identify the possible leakage site of the thoracic duct. The images showed increased 99mTc-dextran but unimpressive 99mTc-sulfur colloid activity at the leakage site. Based on the results, this patient received surgery anastomosing the thoracic duct and the azygos vein.