Detection of chylothorax and cervical cystic hygroma in hydrops fetalis using lymphoscintigraphy

A 2-month-old boy was diagnosed as having nonimmune hydrops fetalis. Lymphoscintigraphy of the lower extremities revealed accumulation of radiotracer in the middle mediastinum on both sides indicating leakage of lymphatic flow from the thoracic duct at 1 hour. There was visualization of radiotracer in both lung fields suggestive of chylothorax. Radioactivity was noted accumulating in the neck consistent with the areas of cystic hygromas on the 4-hour image. Visualization of the cystic hygromas was believed to be the result of feeding of the lymphatic flow from the tributaries of the right lymphatic trunk and thoracic duct or aberrant lymphatic drainage pathways.