We have located links that may give you full text access.
Abnormal Pulmonary Lymphatic Flow in Patients with Lymphatic Anomalies and Respiratory Compromise.
Chest 2020 March 25
BACKGROUND: Pulmonary involvement in lymphatic anomalies (LA) is associated with significant morbidity and mortality. Recently described Dynamic Contrast Enhanced Magnetic Resonance lymphangiography (DCMRL) is capable of imaging the lymphatic system in a variety of pulmonary lymphatic disorders.
RESEARCH QUESTION: The objective of this study is to describe the central lymphatic anatomy in patients with LA and pulmonary involvement on DCMRL.
STUDY DESIGN AND METHODS: This prospective observational study enrolled 16 LA patients (mean age 17 years, range 6-63, F/M-9/7) with pulmonary involvement. All patients underwent DCMRL. The lymphatic system was assessed for the presence of mediastinal masses, interstitial lung disease, size and tortuosity of the thoracic duct (TD) and presence of abnormal pulmonary lymphatic flow.
RESULTS: T2 weighted imaging showed: Mediastinal soft tissue masses in 10 patients, diffuse pulmonary interstitial thickening in 13 patients, bone involvement in 15 patients. DCMRL revealed abnormal pulmonary lymphatic flow in 14/16 patients. Abnormal pulmonary lymphatic flow originated from the TD in 3/14, retroperitoneum in 6/14, and both TD and retroperitoneum in 4/14. In 9/16 patients, the TD was dilated and tortuous. In two patients, the TD was not identified and in 5 patients, it was normal.
INTERPRETATION: Abnormal pulmonary lymphatic flow/ perfusion from the TD or retroperitoneum into lung parenchyma occurred in the majority of patients in this study. These findings can explain the interstitial lung disease and chylothorax resulting in deterioration of respiratory function in these patients. Future studies will determine, if mechanical cessation of this abnormal flow can improve pulmonary function and prolong survival in LA patients.
RESEARCH QUESTION: The objective of this study is to describe the central lymphatic anatomy in patients with LA and pulmonary involvement on DCMRL.
STUDY DESIGN AND METHODS: This prospective observational study enrolled 16 LA patients (mean age 17 years, range 6-63, F/M-9/7) with pulmonary involvement. All patients underwent DCMRL. The lymphatic system was assessed for the presence of mediastinal masses, interstitial lung disease, size and tortuosity of the thoracic duct (TD) and presence of abnormal pulmonary lymphatic flow.
RESULTS: T2 weighted imaging showed: Mediastinal soft tissue masses in 10 patients, diffuse pulmonary interstitial thickening in 13 patients, bone involvement in 15 patients. DCMRL revealed abnormal pulmonary lymphatic flow in 14/16 patients. Abnormal pulmonary lymphatic flow originated from the TD in 3/14, retroperitoneum in 6/14, and both TD and retroperitoneum in 4/14. In 9/16 patients, the TD was dilated and tortuous. In two patients, the TD was not identified and in 5 patients, it was normal.
INTERPRETATION: Abnormal pulmonary lymphatic flow/ perfusion from the TD or retroperitoneum into lung parenchyma occurred in the majority of patients in this study. These findings can explain the interstitial lung disease and chylothorax resulting in deterioration of respiratory function in these patients. Future studies will determine, if mechanical cessation of this abnormal flow can improve pulmonary function and prolong survival in LA patients.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app