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J Thorac Cardiovasc Surg 2001;122:838-840
© 2001 The American Association for Thoracic Surgery

Brief Communications

Scintigraphic distribution of lymphatic flow in the mediastinum after oral administration of radiolabeled lipid and its influx into blood circulation

Tetsu Sado, MD, Masami Sato, MD, Motoyasu Sagawa, MD, Kazuyoshi Shimada, MD, Yoshinori Okada, MD, Yuji Matsumura, MD, Tatsuo Tanita, MD, Takashi Kondo, MD, Sendai, Japan

From the Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.

This study was partly supported by grants-in-aid from the Ministry of Education, Science, Sports and Culture of the Japanese Government.

Received for publication Feb 2, 2001. Accepted for publication Feb 28, 2001. Address for reprints: Masami Sato, MD, the Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan (E-mail: m-sato@idac. tohoku.ac.jp).

During thoracic operations, it is sometimes difficult to determine the route of collateral circulation of the thoracic duct, the site of chyle leakage, or both. In addition, the dynamics of lymph flow in the thoracic duct in diseased patients are impossible to understand with routine radiologic examinations, such as plain film, magnetic resonance imaging, and chest computed tomography (CT). Several diseases involve the thoracic duct, such as chylothorax,Go Go 1,2 lymphangiomyomatosis, and lymphangiectasia.Go 3 We herein report the case of a patient with a disorder of the thoracic duct in whom we successfully detected multiple flow routes of chyle, its abnormal accumulation in the mediastinum, and its influx into the blood circulation after the oral administration of iodine 123–labeled (123I) 15-(p-iodophenyl)-3-R, S-methyl pentadecanoic acid (BMIPP).Go 4

The patient was a 50-year-old woman who had an abnormal shadow in the medial side of the right lower lung field. Chest CT revealed a tumor-like soft tissue mass 3 x 3 cm in size with fat density in the right lower anterior mediastinum and right thoracic effusion, suggesting diaphragmatic hernia (Figure 1, A). She was transferred to our hospital because of a slight increase of tumor size and dyspnea, and thoracotomy was carried out in June 1999. Operative findings showed a yellow, solid . . . [Full Text of this Article]






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