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Lymphoscintigraphy using (99m)Tc filtered sulfur colloid in chylothorax: a case report
B Bybel1, D R Neumann, B Y Kim
1Department of Nuclear Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. bybelb@ccf.org
Journal of Nuclear Medicine Technology
|April 3, 2001
Summary
Filtered sulfur colloid successfully diagnosed chylothorax in a patient with esophageal cancer after surgery. This imaging technique confirmed the cause of recurring pleural effusion when other methods failed.
Area of Science:
- Medical Imaging
- Thoracic Surgery
- Gastroenterology
Background:
- Esophageal carcinoma necessitates surgical intervention, often involving esophagectomy.
- Post-esophagectomy complications can include recurring pleural effusions, requiring diagnostic investigation.
- Conventional lymphangiography may not always be successful in identifying the cause of pleural effusions.
Observation:
- A 66-year-old male patient developed a recurring right pleural effusion after esophagectomy for esophageal carcinoma.
- Initial attempts at lymphangiography to diagnose the effusion were unsuccessful.
- Radiolabeled tracers like albumin, dextran, or nanocolloid were unavailable for lymphoscintigraphy.
Findings:
- Filtered sulfur colloid (0.1 µm) was utilized as an alternative tracer for lymphoscintigraphy.
- The lymphoscintigraphy procedure successfully confirmed chylothorax as the cause of the pleural effusion.
- This highlights the utility of filtered sulfur colloid in specific diagnostic scenarios.
Implications:
- Filtered sulfur colloid can serve as a viable alternative tracer for lymphoscintigraphy when standard agents are unavailable.
- Accurate diagnosis of chylothorax is crucial for appropriate management following thoracic surgery.
- This case demonstrates adaptability in diagnostic imaging techniques for complex postoperative complications.
