Thoracic duct leakage in a patient with Type B-Non-Hodgkin lymphoma treated with transvenous retrograde access embolization: a case report

Thoracic duct leakage in a patient with Type B-Non-Hodgkin lymphoma treated with transvenous retrograde access embolization: a case report

Authors

  • Marcello Petrini 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy
  • Davide Colombi 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy
  • Flavio Cesare Bodini 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy
  • Nicola Morelli 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy
  • Corrado Ciatti Guglielmo da Saliceto Hospital, Department of Orthopaedics and Traumatology, Via Taverna 49, 29121, Piacenza, Italy https://orcid.org/0000-0002-7094-4344
  • Fabrizio Quattrini Guglielmo da Saliceto Hospital, Department of Orthopaedics and Traumatology, Via Taverna 49, 29121, Piacenza, Italy
  • Pietro Maniscalco Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Emanuele Michieletti 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy

Keywords:

Lymphangiography, radiology, interventional, embolization, chylothorax, thoracic duct

Abstract

Thoracic duct (TD) is the largest lymphatic vessel in the body and drains the lymph at the junction between the left subclavian and jugular veins. Chylothorax (CTX) represents an accumulation of lymphatic fluid in the pleural space. We present a case of a 65 years-old man with an histologically diagnosed mediastinal type B non-Hodgkin Lymphoma, treated with chemo-immunotherapy. CT scan during follow up showed significant left side pleural effusion, amounting to 2.8 litres after drainage. Conservative treatment with low fat parenteral nutrition was started without reduction of drainage output, then lymphangiography (LP) with Lipiodol was performed demonstrating a leak in the distal TD. CTX increased in the following days, and a further LP was performed. Using transvenous retrograde access we catheterized TD at the left subclavian jugular veins using a microcatheter. The leak was treated with multiple conventional and controlled delivery microcroils and cyanoacrylate, obtaining complete embolization without residual leak.

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Published

31-01-2023

How to Cite

1.
Petrini M, Colombi D, Bodini FC, Morelli N, Ciatti C, Quattrini F, et al. Thoracic duct leakage in a patient with Type B-Non-Hodgkin lymphoma treated with transvenous retrograde access embolization: a case report. Acta Biomed [Internet]. 2023 Jan. 31 [cited 2024 Jul. 16];94(S1):e2023043. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/12732