Unusual vanishing interstitial lymphatic "pearls" in a patient presenting with extensive interstitial and mediastinal MDCT features of acute cardiogenic failure related to bradycardia and mitral regurgitation.
Thoracic multidetector computed tomography-MDCT-was simultaneously performed during emergency abdominal CT in a patient presenting with abdominal pain and acute cardiogenic edema related to sick sinus syndrome and mitral prolapse with regurgitation. A constellation of severe but completely reversible interstitial and mediastinal features was found comprising pleural effusions, diffuse alveolar ground glass, thickening of the bronchial walls and septal lines, hazy infiltration of the mediastinal fat, and enlarged lymphatic nodes. Multiple atypical hypodense nodular "pearls" were also found. These oval shape or fusiform pearls were distributed along the thickened septal lines and disappeared completely after treatment. The hypothesis of transient lymphatic ectasia or lakes is proposed for these never previously described abnormalities.
Department of Diagnostic Radiology, Clinique St Luc, Rue St Luc 8, 5004, Bouge (Namur), Belgium, bcoulier@skynet.be.
Bruno
B
Coulier
Elie
E
El Khoury
Fabrice C
FC
Deprez
Benoît
B
Ghaye
Stephane
S
Van den Broeck
Hussein
H
Tourmous
D000369:Aged, 80 and over; D001919:Bradycardia / Q000150:complications*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000150:complications*; D008945:Mitral Valve Prolapse / Q000150:complications; D061330:Multidetector Computed Tomography; D013902:Radiography, Thoracic; D012804:Sick Sinus Syndrome / Q000000981:diagnostic imaging