Li XP, Zhang Y, Sun XL, Hao K, Liu MK, Hao Q, Wang RG. Lymphatic plastic bronchitis and primary chylothorax: A study based on computed tomography lymphangiography. World J Clin Cases 2024; 12(14): 2350-2358 [PMID: 38765753 DOI: 10.12998/wjcc.v12.i14.2350]
Corresponding Author of This Article
Ren-Gui Wang, MD, PhD, Chief Doctor, Chief Physician, Doctor, Full Professor, Professor, Department of Radiology, Beijing Shijitan Hospital Affiliated to Capital Medical University, No. 10 Yangfangdian 1 Road, Chaoyang District, Beijing 100038, China. wangrg@bjsjth.cn
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2024; 12(14): 2350-2358 Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2350
Lymphatic plastic bronchitis and primary chylothorax: A study based on computed tomography lymphangiography
Xing-Peng Li, Yan Zhang, Xiao-Li Sun, Kun Hao, Meng-Ke Liu, Qi Hao, Ren-Gui Wang
Xing-Peng Li, Xiao-Li Sun, Meng-Ke Liu, Ren-Gui Wang, Department of Radiology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
Yan Zhang, Department of Radiology, Qilu Hospital, Shandong University, Jinan 250063, Shandong Province, China
Kun Hao, Department of Lymph Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
Qi Hao, Department of Radiology, People's Hospital of Peking University, The Second School of Clinical Medicine of Peking University, Beijing 100034, China
Co-first authors: Xing-Peng Li and Yan Zhang.
Author contributions: Li XP and Zhang Y contributed equally to this work. Li XP, Zhang Y, and Wang RG were the guarantors of the integrity of the entire study; Li XP, Zhang Y, Sun XL, and Wang RG performed the study concept and design; Li XP and Hao Q performed the literature study; Hao K and Liu MK pro conducted the study; Li XP and Zhang Y conducted the experimental study; Li XP, Zhang Y, and Hao K conducted the statistical analysis; Sun XL, Hao K, and Wang RG prepare the manuscript; Sun XL, Hao K, and Wang RG wrote the manuscript. All authors have access to the data and played a role in writing this manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of Beijing Shijitan Hospital Affiliated to Capital Medical University.
Informed consent statement: The requirement for informed consent to review medical records and images was waived because this was a retrospective study. The presented data are anonymized and risk of identification is low.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author at wangrg@bjsjth.cn.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ren-Gui Wang, MD, PhD, Chief Doctor, Chief Physician, Doctor, Full Professor, Professor, Department of Radiology, Beijing Shijitan Hospital Affiliated to Capital Medical University, No. 10 Yangfangdian 1 Road, Chaoyang District, Beijing 100038, China. wangrg@bjsjth.cn
Received: February 4, 2024 Revised: March 9, 2024 Accepted: April 7, 2024 Published online: May 16, 2024 Processing time: 90 Days and 21.2 Hours
Abstract
BACKGROUND
This study presents an evaluation of the computed tomography lymphangiography (CTL) features of lymphatic plastic bronchitis (PB) and primary chylothorax to improve the diagnostic accuracy for these two diseases.
AIM
To improve the diagnosis of lymphatic PB or primary chylothorax, a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.
METHODS
The clinical and CTL data of 71 patients (20 with lymphatic PB, 41 with primary chylothorax, and 10 with lymphatic PB with primary chylothorax) were collected retrospectively. CTL was performed in all patients. The clinical manifestations, CTL findings, and conventional chest CT findings of the three groups of patients were compared. The chi-square test or Fisher's exact test was used to compare the differences among the three groups. A difference was considered to be statistically significant when P < 0.05.
RESULTS
(1) The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows: Thoracic duct outlet in 14 (70.0%), 33 (80.5%) and 8 (80.0%) patients; peritracheal region in 18 (90.0%), 15 (36.6%) and 8 (80.0%) patients; pleura in 6 (30.0%), 33 (80.5%) and 9 (90.0%) patients; pericardium in 6 (30.0%), 6 (14.6%) and 4 (40.0%) patients; and hilum in 16 (80.0%), 11 (26.8%) and 7 (70.0%) patients; and (2) the abnormalities on conventional chest CT in the three groups were as follows: Ground-glass opacity in 19 (95.0%), 18 (43.9%) and 8 (80.0%) patients; atelectasis in 4 (20.0%), 26 (63.4%) and 7 (70.0%) patients; interlobular septal thickening in 12 (60.0%), 11 (26.8%) and 3 (30.0%) patients; bronchovascular bundle thickening in 14 (70.0%), 6 (14.6%) and 4 (40.0%) patients; localized mediastinal changes in 14 (70.0%), 14 (34.1%), and 7 (70.0%) patients; diffuse mediastinal changes in 6 (30.0%), 5 (12.2%), and 3 (30.0%) patients; cystic lesions in the axilla in 2 (10.0%), 6 (14.6%), and 2 (20.0%) patients; and cystic lesions in the chest wall in 0 (0%), 2 (4.9%), and 2 (4.9%) patients.
CONCLUSION
CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax. This method is an excellent tool for diagnosing these two diseases.
Core Tip: Lymphatic plastic bronchitis and primary chylothorax are rare lymphatic drainage disorders. The pathological and physiological mechanisms, clinical manifestations, and imaging findings of the two are similar, making differential diagnosis difficult. Computed tomography lymphangiography (CTL) is an appropriate method to detect abnormal lymphatic vessels and pulmonary abnormalities. CTL is an effective diagnostic method for distinguishing between the two diseases.
