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

Yadav, Naveen; Taywade, Sameer; Kumar, Rajesh; Prashanth, Arun; Saxena, Rahul

doi:10.1186/s41824-021-00111-4

Cited by 2 publications

(3 citation statements)

References 15 publications

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Section: Introductionmentioning

confidence: 99%

“…Accurate diagnosis is crucial for the effective management of the progress of chylothorax [15]. Diagnosis usually begins with the pleural effusion analysis, the biochemical parameters of which include the parameters of triglyceride, cholesterol, total proteins, and LDH values [15]. However, con rming a true chylothorax often requires thoracocentesis sampling, even multiple samplings, which is an invasive and uncomfortable procedure that requires skilled operators and patient cooperation [16].…”

Section: Introductionmentioning

confidence: 99%

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Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters

Zhang

Wang

et al. 2023

Preprint

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Background Chylothorax is a condition that can be challenging to diagnose due to its nonspecific clinical presentation. Several biochemical parameters of chylous pleural effusion have been identified as important indicators for the diagnosis of chylothorax. Lymphoscintigraphy, a non-invasive imaging technique, is also used to evaluate chylothorax and determine the location of chyle leakage. This study aimed to evaluate the correlation between the biochemical parameters of chylous pleural effusion and 99mTc-dextran (DX) lymphoscintigraphy in diagnosing chylothorax. Material and methods A total of 120 patients were enrolled, 83 of the patients had unilateral chylothorax, and 37 had bilateral chylothorax. All patients conducted both 99mTc-DX lymphoscintigraphy and pleural effusion laboratory analysis. The images were classified into positive and negative groups based on whether an abnormal accumulation of the radioactive tracer was observed in the thorax on 99mTc-DX lymphoscintigraphy. And the biochemical parameters of the two groups were compared. Results Among these patients, 101 (84.17%) had exudative effusions, and 19 (15.83%) had transudative effusions, according to the levels of pleural effusion protein, lactate dehydrogenase and cholesterol. Abnormal tracer accumulation in thorax was observed in 83 patients (69.17%). Exudative and transudative chylothorax are not associated with lymphoscintigraphy results (P = 0.597). In all biochemical parameters, lymphoscintigraphy positive group had significantly higher levels of pleural effusion triglyceride and pleural effusion triglyceride/serum triglyceride ratio compared with negative group (P = 0.000 and P = 0.005). The cutoff values that we identified for pleural effusion triglycerides and pleural effusion triglyceride/serum triglyceride ratio were 2.870 mmol/L and 4.625, respectively, which can facilitate differentiating the positive and negative results on lymphoscintigraphy. Conclusion Lymphoscintigraphy technique is a reliable diagnostic tool for the qualitative evaluation of chylous pleural effusion. Higher pleural effusion triglyceride level and pleural effusion triglyceride/serum triglyceride ratio indicate a positive result in patients with chylothorax on lymphoscintigraphy, and the cutoff values of 2.870 mmol/L and 4.625 can help with the diagnosis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters

Zhang

Wang

et al. 2023

Preprint

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“…Accurate diagnosis is imperative for the efficacious management of chylothorax progression [13]. Diagnostic process entails an examination of the pleural fluid, whereby a chylous effusion typically exhibits elevated triglyceride levels exceeding 110 mg/dl, reduced cholesterol levels below 200 mg/dl, and the presence of chylomicrons [10,14,15].…”

Section: Introductionmentioning

confidence: 99%

Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters

Zhang

Wang

et al. 2023

EJNMMI Res

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Background Chylothorax is a condition that can be challenging to diagnose due to its nonspecific clinical presentation. Several biochemical parameters of chylous pleural effusion have been identified as important indicators for the diagnosis of chylothorax. Lymphoscintigraphy is utilized to assess chylothorax and determine the location of chyle leakage. The present study aimed to evaluate the correlation between the biochemical parameters of chylous pleural effusion and 99mTc-dextran (99mTc-DX) lymphoscintigraphy in diagnosing chylothorax. Material and methods A total of 120 patients were enrolled in the study, 83 of the patients with unilateral chylothorax, and 37 with bilateral chylothorax. All patients underwent both 99mTc-DX lymphoscintigraphy and pleural effusion laboratory analysis. The 99mTc-DX lymphoscintigraphy images were categorized as positive or negative groups based on the presence or absence of abnormal radioactive tracer accumulation in the thorax, respectively. The biochemical parameters of the two groups were subsequently compared. Results Among these patients, 101 (84.17%) had exudative effusions, while 19 (15.83%) had transudative effusions, as determined by the levels of pleural effusion protein, lactate dehydrogenase and cholesterol. Abnormal tracer accumulation in thorax was observed in 82 patients (68.33%). Our findings indicated that lymphoscintigraphy results were not associated with exudative and transudative chylothorax (P = 0.597). The lymphoscintigraphy positive group displayed significantly higher levels of pleural effusion triglyceride and pleural effusion triglyceride/serum triglyceride ratio in all biochemical parameters, compared to the negative group (P = 0.000 and P = 0.005). We identified cutoff values of 2.870 mmol/L for pleural effusion triglycerides and 4.625 for pleural effusion triglyceride/serum triglyceride ratio, respectively, which can facilitate differentiating the positive and negative cases on lymphoscintigraphy. Conclusion Lymphoscintigraphy technique is a dependable diagnostic tool for the qualitative assessment of chylous pleural effusion. Higher pleural effusion triglyceride level and pleural effusion triglyceride/serum triglyceride ratio indicate a positive result in patients with chylothorax on lymphoscintigraphy, with the cutoff values of 2.870 mmol/L and 4.625 aiding in the diagnosis.

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

Cited by 2 publications

References 15 publications

Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters

Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters

Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters

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