CTICasesContrast Reflux into the Thoracic Duct
Imaging findings
Contrast-enhanced chest CT with injection via the left upper extremity shows dense contrast agent refluxing into the thoracic duct. The opacified duct is clearly visible tracing down through the posterior mediastinum.
Key takeaways
Contrast reflux into the thoracic duct is a benign, incidental finding that can occur during upper extremity injections, likely due to an incompetent lymphatic-venous valve at the junction of the thoracic duct and the subclavian vein. Recognizing this normal anatomic variant prevents it from being misidentified as a pathological vascular structure or active extravasation.
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