Thoracic Duct Cyst: A Case Report and Review of 29 Cases

Abstract

Cysts of the thoracic duct are rare. We report a case of a cervical thoracic duct cyst and review 29 thoracic duct cysts reported previously (19 mediastinal, 9 cervical, and 1 abdominal). The mean age of the patients was 47.6 years (range 17 to 86 years). Fourteen (46.7%) of the patients were asymptomatic. When symptoms were present, they ranged from retrosternal pain, dysphagia, and dyspnea to respiratory insufficiency and superior vena cava compression. Diagnosis of the cyst can be made after computed tomography or ultrasonography. The cystic fluid contains T lymphocytes and triglycerides in excess. The symptoms in a patient with a thoracic duct cyst are related to compression of adjacent structures. The most profound symptoms are likely to be produced by mediastinal cysts above the aortic arch. Treatment consists of surgical removal of the cyst and ligation of all lymphatics connected to the cyst.

A Giant Thoracic Duct Cyst as the Cause of Abdomen Pain: A Case Report and Review of the Literature

“…According to Mattila 30 cases of thoracic duct cysts have been reported since 1999. 3) However, in Karajiannis' s report published in 2000, the number of cases was 27. 4) By 2009, Mortman summarized and reported the number of thoracic duct cysts to be less than 30.…”

“…No cases of malignant transformation has been reported. 1,3) So surgery is optional for the patient with a small and asymptomatic cyst.…”

Thoracic Duct Cyst in Mediastinum - A case report -

“…Supradiaphragmatic thoracic duct cysts are typically found in the neck. Mediastinal thoracic duct cysts are quite uncommon [1-3]. The cysts are symptomatic because of the pressure on adjacent structures.…”

Spontaneous cervical lymphocele

“…Six lymphatic primordia (lymph sacs) bud off from venous endothelium in a human embryo. By the end of the ninth week, all but the pair of jugular sacs lose connection with their parent veins 8. A mature thoracic duct conveys the majority of the lymph and chyle into the blood.…”