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Localization of chyle leak with Tc-99m colloid (SPECT/CT)

Case contributed by Brendon Friesen
Diagnosis certain

Presentation

Esophagectomy for esophageal adenocarcinoma - complicated by persistent left chylothorax

Patient Data

Age: 75 years
Gender: Male

Technique:

Planar imaging acquired 2 hours following intradermal administration of Tc-99m antimony colloid between the toes of the left foot (not shown). Then a delayed SPECT-CT was obtained (shown above).

Findings:

Abnormal accumulation of radiotracer in the mediastinum, immediately anteromedial to the descending thoracic aorta at the level of the right pulmonary artery. The radiotracer also accumulates in a left pleural loculated chylothorax (lateral to descending thoracic aorta).

Case Discussion

Tc-99m antimony colloid with SPECT/CT can be used to localize the site of a post-operative chyle leak, which can be helpful for surgical planning.

Acknowledgements:

Dr Dee Nandurkar

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