Cyst of the right lymphatic duct

Stárek, Ivo; Salzman, Richard; Pokorná, Žaneta; Skanderová, Daniela

doi:10.1016/j.anorl.2019.01.002

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…1,2 This canal crosses the diaphragm and goes through the thorax, crossing the esophagus from right to left, runs along the left pleural dome, and flows into the confluence of the subclavian and left internal jugular veins. 3,4 Thus, depending on the location of a wound on its thin wall, lymphorrhea may lead to ascites, right or left chylothorax, or left cervical lymphorrhea. 2 Cervical lymphorrhea are mainly due to iatrogenic trauma, complicating 1% to 3% of cervical surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 2 liters of chyle drains each day into the venous system via the thoracic duct, which includes 14 mL per hour during youth and 100 mL per hour after a meal . This canal crosses the diaphragm and goes through the thorax, crossing the esophagus from right to left, runs along the left pleural dome, and flows into the confluence of the subclavian and left internal jugular veins . Thus, depending on the location of a wound on its thin wall, lymphorrhea may lead to ascites, right or left chylothorax, or left cervical lymphorrhea …”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Cervical Swelling

Hervochon

Bonnefont

Tankéré

2021

JAMA Otolaryngol Head Neck Surg

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A 56-year-old patient with no medical history presented spontaneously to the emergency department of our university hospital (Assistance Publique Hôpitaux de Paris) for bilateral neck swelling that had developed over 24 hours. The patient had no traumatic or iatrogenic triggers. He reported an edema of the lower lip that resolved spontaneously the day before. He had no dyspnea nor dysphagia, but did have a discrete dysphonia. He had no fever. Neck swelling was global, bilateral, and painless, and was most severe on the left side. There was a rash, the border of which was marked with a felt pen. Nasofibroscopy results showed a normal airway with a posterior pharyngeal wall bulging. Oropharyngeal and oral cavity examination results were normal, with no trismus.A contrast-enhanced computed tomography (CT) scan showed a large retropharyngeal fluid accumulation of 2 × 10 × 6 cm that extended laterally to the vascular spaces, especially on the left side (Figure , A and B). This was associated with infiltration of the mediastinal fat and a thin left pleural effusion. There was no vascular thrombosis or dental abnormality. Hyperleukocytosis levels were 12 000/mL. We did not have the result of the C reactive protein assay. Diagnosis B. Spontaneous lymphorrheaBecause of the rash, acute neck swelling, large cervical fluid accumulation with mediastinal infiltration, and hyperleukocytosis, we treated the patient as if he had cervical necrotizing fasciitis. He immediately underwent an operation. Orotracheal intubation was easily performed. The left cervicectomy and opening of the superficial fascia revealed a milky fluid that was coming from all the soft tissues. The introduction of the surgeon's finger allowed an easy and large retropharyngeal and retroesophageal dissection from the skull base to the posterior mediastinum.Samples were sent to bacteriology, mycobacteriology, anatomopathology, and biochemistry laboratories. Two lavage modules

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous Cervical Swelling

Hervochon

Bonnefont

Tankéré

2021

JAMA Otolaryngol Head Neck Surg

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“…They may lead to a postoperative cervical lymphorrhea and development of chylous fistula, chylothorax or an exceptionally rare lymphocele 8 . The cervical lymphocele (chyloma) is defined as a circumscribed lymph collection in a neocavity lacking an epithelial lining, which is predominantly left-sided 9,10 . These lesions may also develop following other neck surgical procedures, trauma or spontaneously, probably due to the congenital or acquired lymphatic vessel wall weakness and degeneration or obstruction at the terminal end of the duct.…”

Section: Introductionmentioning

confidence: 99%

Cervical lymphocele: A rare complication following salvage surgery for ocular adnexal apocrine adenocarcinoma. A case report and review of the literature

et al. 2022

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Background. An ocular adnexal apocrine adenocarcinoma (OAAA) is an extremely rare, but potentially aggressive and life-threatening tumor with ill-defined management based only on recommendations from a limited number of reported cases. The development of cervical lymphocele following neck dissection is a very rare complication, but one with well established methods for prevention and treatment. Here we describe a previously unreported case of salvage surgery including neck dissection for OAAA in addition to an emergence of cervical lymphocele. A literature review of current knowledge on both pathological conditions is included. Methods and Results. A 58-year-old man suffering from OAAA, previously treated with multiple eye-sparing excisions and adjuvant proton therapy, underwent salvage surgery for locoregional recurrence of the tumor. A partial orbitectomy with orbital exenteration, primary reconstruction and left-sided neck dissection was performed. The procedure was complicated by a cervical lymphocele resolved after the surgical therapy. The patient remained disease-free during the one-year follow-up. Conclusion.OAAA is a locally aggressive tumor with potential to local or distant metastatic spread. Whole-body staging, regular clinico-radiological follow-up and stage-dependent therapy with surgery as the first-choice treatment is required. A cervical lymphocele as a complication of especially left-sided neck dissection is managed with a conservative or surgical therapy according to the level of lymph leakage, extent and localization of lesions, presence of local or systemic disorders and the period from primary surgery.

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The right lymphatic duct: basic anatomy and clinical relevance

Kanavaros,

Karatzias,

Papoudou-Bai

et al. 2024

Vasa

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Summary: The anatomical variability of the thoracic duct and the right lymphatic duct predisposes them to inadvertent damage following head and neck surgery thereby leading to chyle leak which is an uncommon complication with potentially significant associated morbidity. Although chyle leak is predominately associated with left-sided neck surgery, it also occurs as a complication of the right-sided neck dissection. Variable figures concerning chyle leakage after right-sided neck dissections were reported, ranging from 0 per cent to higher prevalences such as 14%, 24%, 33% and 60% of total cases of chyle leakages associated with neck surgery. The right-sided complications may implicate the right lymphatic duct and right-sided terminations of the thoracic duct into the venous system which occur in about 1-6% of humans. Other clinically relevant conditions involving the right-sided major lymphatic vessels include chyle leaks following right anterior cervical spine surgery, cysts of the right lymphatic duct and dilatation of the right lymphatic duct in the setting of recurrent cervical swelling. This article presents a review of the literature concerning the basic anatomy and the clinical relevance of the right lymphatic duct and the right-sided terminations of the thoracic duct into the venous circulation.

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Cyst of the right lymphatic duct

Cited by 3 publications

References 9 publications

Spontaneous Cervical Swelling

Spontaneous Cervical Swelling

Cervical lymphocele: A rare complication following salvage surgery for ocular adnexal apocrine adenocarcinoma. A case report and review of the literature

The right lymphatic duct: basic anatomy and clinical relevance

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