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A case of idiopathic lymph leakage in the neck
Masanobu Suzuki1, Shinya Morita, Keiji Iizuka
1Department of Otolaryngology, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro City, Hokkaido, Japan. masanobuwork@yahoo.co.jp
Insights
This case report details a rare instance of idiopathic neck lymph leakage in a patient presenting with sudden swelling. The condition, characterized by serous fluid discharge, was successfully managed with drainage and dietary changes.
Area of Science:
- Medicine
- Vascular Surgery
- Diagnostic Imaging
Background:
- Neck lymph leakage typically occurs post-trauma or surgery.
- Idiopathic cases are exceedingly rare, with limited documented instances.
Observation:
- A 48-year-old female presented with acute left neck swelling and tenderness.
- Imaging revealed significant effusions compressing the airway.
- Intraoperative findings included transparent, colorless lymph fluid and dilated lymphatic ducts without apparent injury or causative lesions.
Findings:
- Diagnosis of idiopathic lymph leakage was made due to unexplained serous discharge.
- The patient's airway was compromised by the fluid accumulation.
- No underlying disease structures like tumors were identified as the cause.
Implications:
- This case highlights a unique presentation of lymph leakage in the neck.
- Successful management involved incisional drainage and dietary modification.
- The rarity of this condition underscores the need for awareness in clinical practice.
Abstract:
A 48-year-old female patient was seen in our institution complaining of sudden onset of swelling and tenderness in the left side of her neck. Computed tomography and magnetic resonance imaging revealed abundant effusions in this area. Since these narrowed the patient's airway, we performed incisional drainage and intra-operatively we observed a transparent, colorless lymph fluid that oozed from the operative field, which was mainly a fatty layer at the supraclavicular area. Dilated lymphatic ducts were seen along the carotid artery and internal jugular vein, but damaged lymphatic ducts and obvious causative disease structures like tumorous lesions were not seen. Idiopathic lymph leakage was diagnosed due to the serous discharge from the left side of the neck and no apparent causative disease. The patient was successfully treated with incisional drainage and dietary restriction. Lymph leakage in the neck is more common after trauma or surgery. To our knowledge, no similar cases have ever been reported.
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