Lymphoscintigraphy readily provides confirmation of chylothorax but
not detailed localization of the leakage site. A 77-year-old woman developed
traumatic chylothorax and underwent lymphoscintigraphy with radiolabeled
albumin to identify the site of lymph leakage. Dynamic imaging demonstrated
appearance of focal activity presumably in the upper mediastinum, followed by
spread to the left hemithorax. Subsequently, SPECT/CT showed that the leakage
site was located in the left side of the upper mediastinum, and this location
was confirmed during video-assisted thoracoscopic surgery. Dynamic imaging
demonstrated the site of first appearance of abnormal activity, and SPECT/CT
enabled detailed localization of the abnormal activity with anatomic
correlation. The combination of dynamic imaging with SPECT/CT appears to be
recommendable for lymphoscintigraphic assessment of chylothorax.
Cite this paper
A. Ohtsuka, Y. Inoue, Y. Asano, R. Woodhams and K. Shiomi, "Lymphoscintigraphy Using Dynamic Imaging and SPECT/CT in Chylothorax," Open Journal of Medical Imaging, Vol. 3 No. 3, 2013, pp. 86-89. doi: 10.4236/ojmi.2013.33013.
 I. E. Platis and C. E. Nwogu, “Chylothorax,” Thoracic Surgery Clinics, Vol. 16, No. 3, 2006, pp. 209-214.
 V. G. Valentine and T. A. Raffin, “The Management of Chylothorax,” Chest, Vol. 102, No. 2, 1992, pp. 586-591.
 S. Heyman and R. Wilmott, “Chylothorax on Technetium-99m Antimony Sulfide Colloid Scan,” Journal of Nuclear Medicine, Vol. 27, No. 11, 1986, pp. 1783-1784.
 Y. Inoue, T. Otake, J. Nishikawa and Y. Sasaki, “Lymphoscintigraphy Using Tc-99m Human Serum Albumin in Chylothorax,” Clinical Nuclear Medicine, Vol. 22, No. 1, 1997, p. 60. doi:10.1097/00003072-199701000-00018
 K. Suga, N. Kume, A. Hara, G. Miura, N. Matsunaga, K. Sugi, et al., “Abnormal Lymphatic Flow Demonstrated by Lymphoscintigraphy in Chylothorax Correlation with Lymphography,” Clinical Nuclear Medicine, Vol. 24, No. 9, 1999, pp. 716-717.
 T. Stavngaard, J. Mortensen, J. Brenoe and L. B. Svendsen, “Lymphoscintigraphy Using Technetium-99m Human Serum Albumin in Chylothorax,” The Thoracic and Cardiovascular Surgeon, Vol. 50, No. 4, 2002, pp. 250-252. doi:10.1055/s-2002-33099
 M. Momose, S. Kawakami, T. Koizumi, K. Yoshida, S. Kanda and R. Kondo, et al., “Lymphoscintigraphy Using Technetium-99m HSA-DTPA with SPECT/CT in Chylothorax after Childbirth,” Radiation Medicine, Vol. 26, No. 8, 2008, pp. 508-511.
 D. Kayano, J. Taki, H. Wakabayashi and S. Kinuya, “Tc-99m Human Serum Albumin Lymphoscintigraphy with SPECT/CT in Chylothorax,” Clinical Nuclear Medicine, Vol. 36, No. 11, 2011, pp. 1056-1057.
 N. Prevot, O. Tiffet, J. Avet Jr., E. Quak, M. Decousus and F. Dubois, “Lymphoscintigraphy and SPECT/CT Using 99mTc Filtered Sulphur Colloid in Chylothorax,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 38, No. 9, 2011, p. 1746.
 D. J. Boffa, M. J. Sands, T. W. Rice, S. C. Murthy, D. P. Mason, M. A. Geisinger, et al., “A Critical Evaluation of a Percutaneous Diagnostic and Treatment Strategy for Chylothorax after Thoracic Surgery,” European Journal of Cardio-Thoracic Surgery, Vol. 33, No. 3, 2008, pp. 435-439. doi:10.1016/j.ejcts.2007.11.028
 E. Ohtake, K. Matsui, Y. Kobayashi and Y. Ono, “Dynamic Lymphoscintigraphy with Tc-99m Human Serum Albumin,” Radiation Medicine, Vol. 1, No. 2, 1983, pp. 132-136.