Anomalies of thoracic lymph duct drainage demonstrated by lymphoscintigraphy and review of the literature about these anomalies.
OBJECTIVE
To determine the frequency of supradiaphragmatic lymph nodes that receive lymph from the lower limbs and the intraabdominal organs.


METHODS
Three hundred and thirty-four bipedal lymphoscintigraphy results of the lower limbs were reviewed.


RESULTS
Lymph nodes were visualized in only the supraclavicular/retroclavicular (SRC) area in 113 cases (33.2%, 109 on the left and 4 on the right), in only the mediastinum in 5 cases (1.5%), in the mediastinum and the left SRC area in 18 cases (5.5%), in the mediastinum and right SRC area in 2 cases (0.6%), in the mediastinum and both SRC areas in 6 cases (1.8%), and in the mediastinum and as 1 chain draining in the left axilla in 2 cases (0.6%).


CONCLUSIONS
Supradiaphragmatic lymph nodes associated with the thoracic duct and receiving lymph and/or chyle from the infradiaphragmatic body were demonstrated in 43.2% of our patients and in 11.1% of the cases these lymph nodes were not located in the left retroclavicular area. These data should be taken in mind by surgeons when confronting an intrathoracic and even extrathoracic supradiaphragmatic chylous effusion after surgeries which imply lymph nodes and/or lymphatic vessels.
Bourgeois
P
P
Service of Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles (ULB), 121 Bd de Waterloo, B-1000 Brussels, Belgium. pierre.bourgeois@bordet.be
Munck
D
D
Sales
F
F
D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012196:Review Literature as Topic; D013897:Thoracic Duct / Q000002:abnormalities* / Q000000981:diagnostic imaging*