CTICasesPost-Lobectomy Mediastinal Lymphocele Mimicking Recurrent Lymphadenopathy
Imaging findings
A patient with a resected stage IA right lower lobe lung cancer and negative lymph node dissection had a routine six-month surveillance CT showing a new, well-circumscribed, homogeneous water-attenuation structure in the right high paratracheal space, distinct from the normal-appearing residual lymph nodes and not present on the preoperative CT, in the same region where lymph node dissection had been performed.
Key takeaways
A new, homogeneous, water-attenuation paratracheal or mediastinal collection appearing after lymph node dissection should be recognized as a likely postoperative lymphocele rather than mistaken for recurrent or metastatic lymphadenopathy, particularly when the underlying cancer was low stage with negative margins and negative nodes; such collections may persist indefinitely or resolve on their own and warrant interval follow-up rather than alarm.
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