IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Lymphocele of the thoracic duct

Case contributed by Eric F Greif
Diagnosis almost certain

Presentation

Palpable left supraclavicular mass

Patient Data

Age: 75 years
Gender: Female

CT of the neck

ct

Non-enhancing, tubular/multicystic, multicompartmental, fluid-density structure extending from the left supraclavicular region and inferiorly to the left paraesophageal (posterior mediastinum) region to the level of the aortic arch. The lesion is displacing the sternocleidomastoid muscle/internal jugular vein anteriorly and the trachea/esophagus to the right.

CT of the thorax

ct

Tubular/multicystic, multicompartmental, fluid-density structure extends from the left side of the neck and continues to form several cystic/tubular areas in the posterior mediastinum to the retrocrural region at the expected location of the cisterna chyli.

Annotated image

Dilated thoracic duct entering the left subclavian/brachiocephalic vein (yellow arrow).

Case Discussion

This patient had a long standing soft palpable mass in the left side of the neck. A neck CT with IV contrast was performed and the lesion was believed to be a lymphangioma. Subsequently, a non-contrast chest CT was performed and the tubular/cystic mass extended from the left neck to the posterior mediastinum and to the level of the cisterna chyli, consistent with a lymphocele of the thoracic duct.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.