Role of 99mTc sulphur colloid lymphoscintigraphy in a rare case of chylothorax and lymphocele formation post esophageal duplication cyst excision.

Abstract

We report a rare case of chylothorax with lymphocele formation post esophageal duplication cyst (EDC) excision in a 2 year old male child. Patient developed chylothorax after excision of EDC. Pleural fluid cytology showed increased triglycerides and cholesterol levels. Filtered Tc-99m Sulphur colloid lymphoscintigraphy showed abnormal radiotracer uptake in the lower thoracic region on right side corresponding to lymphocele on SPECT-CT images with possible site of leak medially. In addition, Tc-99m pertechnetate scan was done to rule out possibility of residual duplication cyst revealed no abnormality. Patient underwent open and en-masse ligation of the duct. Patient recovered completely post-surgery. This case highlights the importance of lymphoscintigraphy with SPECT-CT in the evaluation of patients with post-operative complications of chylothorax with detection of site of chyle leak.