Thamkittikun C, Tovichien P. Clinical approach for pulmonary lymphatic disorders. World J Clin Cases 2024; 12(27): 6020-6026 [DOI: 10.12998/wjcc.v12.i27.6020]
Corresponding Author of This Article
Prakarn Tovichien, MD, Associate Professor, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand. prakarn.tov@mahidol.edu
Research Domain of This Article
Respiratory System
Article-Type of This Article
Editorial
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. Sep 26, 2024; 12(27): 6020-6026 Published online Sep 26, 2024. doi: 10.12998/wjcc.v12.i27.6020
Clinical approach for pulmonary lymphatic disorders
Chalisa Thamkittikun, Prakarn Tovichien
Chalisa Thamkittikun, Prakarn Tovichien, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Co-first authors: Chalisa Thamkittikun and Prakarn Tovichien.
Author contributions: Thamkittikun C and Tovichien P designed the overall concept, outlined the manuscript, reviewed the literature, and wrote and edited the manuscript; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: Chalisa Thamkittikun and Prakarn Tovichien have nothing to disclose.
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: Prakarn Tovichien, MD, Associate Professor, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand. prakarn.tov@mahidol.edu
Received: April 22, 2024 Revised: June 20, 2024 Accepted: June 25, 2024 Published online: September 26, 2024 Processing time: 99 Days and 23 Hours
Abstract
In this editorial, we discuss the clinical implications of the article “Lymphatic plastic bronchitis and primary chylothorax: A study based on computed tomography lymphangiography” published by Li et al. Pulmonary lymphatic disorders involve abnormalities in the lymphatic tissues within the thoracic cavity. Specifically, pulmonary lymphatic perfusion syndrome describes a condition where the flow of lymphatic fluid in the lungs is redirected towards abnormally widened lymphatic vessels. Clinically, individuals with this syndrome may experience symptoms such as chyloptysis, plastic bronchitis (PB), chylothorax, chylopericardium, and interstitial lung disease. These disorders can be caused by various factors, including PB, chylothorax, and complex lymphatic malformations. Advancements in lymphatic imaging techniques, such as intranodal lymphangiography, computed tomography lymphangiography, and dynamic contrast-enhanced magnetic resonance lymphangiography, have enabled the detection of abnormal lymphatic flow. This has enhanced our understanding of the pathophysiology of these conditions. Additionally, innovative minimally invasive treatments, such as thoracic duct embolization, selective embolization of lymphatic channels, and surgical procedures aim to improve clinical condition of patients and address their dietary needs.
Core Tip: The pulmonary lymphatic perfusion syndrome likely stems from an inherent variation in the lymphatic system, leading to various pulmonary lymphatic disorders. Clinically, it manifests as conditions such as plastic bronchitis, chylothorax, and interstitial lung disease. Recent advancements in dynamic contrast-enhanced magnetic resonance lymphangiography have improved our understanding of these pathophysiologies and contributed to the development of interventional therapies.
