CTICasesLipiodol Embolization into Lung Lymphatics in SVC Syndrome with Chylothorax
Imaging findings
A patient with end-stage renal disease and SVC occlusion presented with a chronic right-sided chylous effusion. Initial CT showed peribronchial fluid cuffs, septal thickening, and ground-glass opacity. Following a lymphangiogram with Lipiodol embolization of the thoracic duct, subsequent CT demonstrated a marked increase in lung attenuation with a crazy paving pattern, septal thickening, fluid cuffs, ground-glass opacity, and high-density material along the thoracic duct and within mediastinal lymph nodes, indicating retrograde lymphatic spread of Lipiodol into the lungs.
Key takeaways
Superior vena cava (SVC) syndrome can be associated with recurrent chylous effusion due to lymphatic congestion and obstruction. Lymphangiographic embolization of the thoracic duct using Lipiodol can result in the retrograde spread of Lipiodol into the lung lymphatics, leading to increased lung attenuation and a crazy paving pattern, which can be observed progressing during and after the procedure.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Epithelioid Mesothelioma (Mass-like)Neoplastic
- Ganglioneuroma (Posterior Mediastinal)Neoplastic
- Ganglioneuroma (Adrenal)Neoplastic
- Hemothorax due to Iatrogenic Intercostal Artery Injury during Biliary Drain PlacementIatrogenic
- Dislodged Transcatheter Aortic Valve Replacement (TAVR) requiring Surgical RetrievalIatrogenic
- Asymmetric Idiopathic Pulmonary Fibrosis (IPF)ILD
- Poland Syndrome with Costal Cartilage AplasiaCongenital
- Non-Resolution of Acute Pulmonary Embolism (Chronic Thromboembolic Occlusion)Vascular
See all cases from November 3, 2016 →