title: Primary chylous vaginal discharge in a 9-year-old girl: CT-lymphangiogram and MR appearance.
abstract: Chylous reflux is a manifestation of primary or secondary lymphatic obstruction. Primary lymphatic obstruction is defined as lymphangiectasia and incompetency of lymphatic valves without an underlying cause. Lymphangiectasia resulting from trauma, neoplasm, irradiation, or inflammation characterizes secondary lymphatic obstruction. Leakage of chyle into the uterus, vagina, bladder, or rectum can occur with either primary or secondary lymphatic obstruction. We report a patient with chylous vaginal discharge, a rare presentation of primary chylous reflux syndrome. CT-lymphangiography and magnetic resonance imaging clearly depicted this disorder. To our knowledge, only 20 cases of chylous vaginal discharge have been reported previously; chylous vaginal drainage occurred in the absence of chylous uterine reflux in only three. Although this is a rare anomaly, chylous reflux should be considered in a child with chronic vaginal discharge and lower extremity swelling.
authors.affiliation: Department of Pediatrics, Medical College of Georgia, Augusta, Georgia, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Shahlaee
authors.forename: E M
authors.initials: EM
authors.lastname: Burton
authors.forename: H
authors.initials: H
authors.lastname: Sabio
authors.forename: L
authors.initials: L
authors.lastname: Plouffe
authors.forename: R
authors.initials: R
authors.lastname: Teeslink
mesh_terms: D002648:Child; D002913:Chyle; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D019522:Vaginal Discharge