CTICasesMediastinal Lymphatic-Venous Malformation
Imaging findings
Neck and chest computed tomography show a complex, fatty, and soft-tissue mass in the anterior mediastinum containing small punctate calcifications and dilated, tortuous vascular channels. Contrast-enhanced magnetic resonance images reveal extensive T2-hyperintense lymphatic spaces alongside enhancing venous channels, including a large macroscopic communication draining directly into the left brachiocephalic vein.
Key takeaways
Combined lymphatic-venous malformations are complex vascular anomalies of the mediastinum that can grow slowly over decades. A key diagnostic feature is the presence of phleboliths, fluid-fluid levels, and macroscopic drainage into major mediastinal veins, which must be carefully evaluated prior to any embolization procedures to prevent systemic embolization of therapeutic agents.
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