Open AccessMR ‐lymphangiography identifies lymphatic pathologies in patients with idiopathic recurrent cervical swelling
Author(s) -
Vach Marius,
Wagenpfeil Julia,
Henkel Andreas,
Strieth Sebastian,
Luetkens Julian Alexander,
Ko YonDschun,
Schild Hans Heinz,
Attenberger Ulrike Irmgard,
Pieper Claus Christian
Publication year - 2022
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.919
Subject(s) - lymphatic system , medicine , thoracic duct , lymph , pathological , lymph duct , lymphatic vessel , swelling , cervical lymph nodes , reflux , radiology , surgery , pathology , disease , cancer , metastasis
Background Idiopathic recurrent cervical swelling may be caused by lymphatic abnormalities. Methods Ten patients (9 females, mean age 51.2 ± 7) with idiopathic recurrent cervical swelling underwent MR‐lymphangiography (MRL). MR‐lymphangiograms were evaluated regarding lymphatic anatomy and flow. Individualized treatment was recommended according to MRL‐findings. Results 8/10 patients presented with left‐sided, 2/10 with right‐sided swelling. Pathological lymph‐flow was identified in all cases: thoracic duct dilatation in patients with left‐sided and right lymphatic duct dilatation in right‐sided swelling, accessory thoracic lymphatics in 7/10 and reflux in 8/10 cases. In two cases, a lymphatic thrombus was identified. After treatment, symptoms resolved completely in 6/10 cases and partially in 1/10 cases. The remaining three patients have intermittent swellings but have no treatment wish. Conclusion Idiopathic recurrent cervical swelling can be caused by lymphatic anomalies. MRL displays impaired lymphatic drainage, lymphatic vessel dilatation, and chylolymphatic reflux as hallmarks of this condition and may aid in targeted treatment planning.