<sup>99m</sup>Tc-Dextran Lymphoscintigraphy SPECT/CT Unveils the Hidden Leakage Site in Recurrent Chylothoraxes.

Xia, Xiaotian; Shao, Fuqiang; Hu, Fan; He, Yong; Cao, Wei · Ann Thorac Surg · 2020

case_report · Level V

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Abstract

Chylothorax is defined as the accumulation of chyle in the pleural space, mainly by damaging to the thoracic duct. <sup>99m</sup>Tc-Dextran is a relatively new tracer for lymphoscintigraphy. A 40-year-old woman had recurrent chylothoraxes after thymoma resection and ligation of the thoracic duct owing to intraoperative suspected thoracic duct injury. She underwent lymphoscintigraphies using <sup>99m</sup>Tc-sulfur colloid and <sup>99m</sup>Tc-dextran, respectively, to identify the possible leakage site of the thoracic duct. The images showed increased <sup>99m</sup>Tc-dextran but unimpressive <sup>99m</sup>Tc-sulfur colloid activity at the leakage site. Based on the results, this patient received surgery anastomosing the thoracic duct and the azygos vein.

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