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Prominent Thoracic Duct in Neck
Richard H. Wiggins, III, MD, CIIP, FSIIM, FAHSE, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Enlarged cervical lymphatic duct
              • Definitions

                • Thoracic duct: Normal anatomical structure draining lymph from abdomen and left chest

              IMAGING

              • General Features

                • Imaging Recommendations

                  • CT Findings

                    • MR Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Bojanapu S et al: Thoracic duct leak. StatPearls, 2021
                                      2. Chen L et al: Application of imaging technique in thoracic duct anatomy. Ann Palliat Med. 9(3):1249-56, 2020
                                      3. Cholet C et al: Nontraumatic chylothorax: nonenhanced MR lymphography. Radiographics. 40(6):1554-73, 2020
                                      4. Witte MH: Thoracic duct decompression: an idea whose time has come - again. Lymphology. 53(2):51-4, 2020
                                      5. Kardos M: Ultrasonographic imaging of the cervical thoracic duct. J Ultrason. 19(78):240-1, 2019
                                      6. Novelli PM et al: Interventional therapies for thoracic duct injury and intractable chylothorax. J Thorac Imaging. 34(4):258-65, 2019
                                      7. Chakedis J et al: Identification of the thoracic duct using indocyanine green during cervical lymphadenectomy. Ann Surg Oncol. 25(12):3711-7, 2018
                                      8. Toliyat M et al: Interventional radiology in the management of thoracic duct injuries: anatomy, techniques and results. Clin Imaging. 42:183-92, 2017
                                      9. Johnson OW et al: The thoracic duct: clinical importance, anatomic variation, imaging, and embolization. Eur Radiol. 26(8):2482-93, 2016
                                      10. Bang JH et al: Anatomic variability of the thoracic duct in pediatric patients with complex congenital heart disease. J Thorac Cardiovasc Surg. 150(3):490-5, 2015
                                      11. Chen JM: The thoracic duct: predictably unpredictable? J Thorac Cardiovasc Surg. 150(3):497, 2015
                                      12. Ebada AH et al: Retroperitoneal intranodal contrast agent injection for lymphangiographic imaging of the thoracic duct in view of percutaneous intervention. J Vasc Interv Radiol. 26(9):1403-5, 2015
                                      13. Karasaki T et al: Imaging of thoracic duct in a patient with right-sided descending aorta. Ann Thorac Surg. 99(2):713, 2015
                                      14. Oya S et al: Oesophageal cancer with an aberrant right subclavian artery accompanied by a thoracic duct anomaly. Eur J Cardiothorac Surg. 48(3):e55-7, 2015
                                      15. Pieper CC et al: Direct cervical puncture for retrograde thoracic duct embolization in a postoperative cervical lymphatic fistula. J Vasc Interv Radiol. 26(9):1405-8, 2015
                                      16. Richards MK et al: A national review of the frequency of minimally invasive surgery among general surgery residents: assessment of ACGME case logs during 2 decades of general surgery resident training. JAMA Surg. 150(2):169-72, 2015
                                      17. Shirakawa Y et al: Prone-position thoracoscopic ligation of the thoracic duct for chyle leak following radical neck dissection in a patient with a right aortic arch. Acta Med Okayama. 69(3):173-6, 2015
                                      18. Veziant J et al: Lymphovenous anastomosis for recurrent swelling syndrome and chylous effusion due to cervical thoracic duct cyst. J Vasc Surg. 62(4):1068-70, 2015
                                      19. Ikeda Y: Thoracoscopic management of cervical thoracic duct injuries after thyroidectomy with lymphadenectomy. Asian J Endosc Surg. 7(1):82-4, 2014
                                      20. Kumar A et al: Primary cervical thoracic duct cyst: a case report and review of the literature. Ear Nose Throat J. 93(7):E17-21, 2014
                                      21. Nakano T et al: Three-dimensional imaging of a thoracic duct cyst before thoracoscopic surgery. Eur J Cardiothorac Surg. 45(3):585, 2014
                                      22. Ohnishi H et al: Life-threatening pulmonary lymphedema secondary to thoracic duct ligation. Intern Med. 53(20):2341-5, 2014
                                      23. Phang K et al: Review of thoracic duct anatomical variations and clinical implications. Clin Anat. 27(4):637-44, 2014
                                      24. W A Aziz WA et al: A unique approach to thoracic duct leak after esophagectomy. Surg Laparosc Endosc Percutan Tech. 24(4):e155-6, 2014
                                      25. Ladinsky HT et al: Thoracic duct injury resulting in abnormal newborn screen. J Allergy Clin Immunol Pract. 1(6):583-8, 2013
                                      26. Gill MT et al: Cervical thoracic duct cyst: Importance of preoperative suspicion for appropriate management of left-sided neck mass. Ear Nose Throat J. 91(12):E13-5, 2012
                                      27. Parker EE et al: MR imaging of the thoracic inlet. Magn Reson Imaging Clin N Am. 16(2):341-53, x, 2008
                                      28. Liu ME et al: Normal CT appearance of the distal thoracic duct. AJR Am J Roentgenol. 187(6):1615-20, 2006
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Enlarged cervical lymphatic duct
                                                  • Definitions

                                                    • Thoracic duct: Normal anatomical structure draining lymph from abdomen and left chest

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • CT Findings

                                                        • MR Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Bojanapu S et al: Thoracic duct leak. StatPearls, 2021
                                                                          2. Chen L et al: Application of imaging technique in thoracic duct anatomy. Ann Palliat Med. 9(3):1249-56, 2020
                                                                          3. Cholet C et al: Nontraumatic chylothorax: nonenhanced MR lymphography. Radiographics. 40(6):1554-73, 2020
                                                                          4. Witte MH: Thoracic duct decompression: an idea whose time has come - again. Lymphology. 53(2):51-4, 2020
                                                                          5. Kardos M: Ultrasonographic imaging of the cervical thoracic duct. J Ultrason. 19(78):240-1, 2019
                                                                          6. Novelli PM et al: Interventional therapies for thoracic duct injury and intractable chylothorax. J Thorac Imaging. 34(4):258-65, 2019
                                                                          7. Chakedis J et al: Identification of the thoracic duct using indocyanine green during cervical lymphadenectomy. Ann Surg Oncol. 25(12):3711-7, 2018
                                                                          8. Toliyat M et al: Interventional radiology in the management of thoracic duct injuries: anatomy, techniques and results. Clin Imaging. 42:183-92, 2017
                                                                          9. Johnson OW et al: The thoracic duct: clinical importance, anatomic variation, imaging, and embolization. Eur Radiol. 26(8):2482-93, 2016
                                                                          10. Bang JH et al: Anatomic variability of the thoracic duct in pediatric patients with complex congenital heart disease. J Thorac Cardiovasc Surg. 150(3):490-5, 2015
                                                                          11. Chen JM: The thoracic duct: predictably unpredictable? J Thorac Cardiovasc Surg. 150(3):497, 2015
                                                                          12. Ebada AH et al: Retroperitoneal intranodal contrast agent injection for lymphangiographic imaging of the thoracic duct in view of percutaneous intervention. J Vasc Interv Radiol. 26(9):1403-5, 2015
                                                                          13. Karasaki T et al: Imaging of thoracic duct in a patient with right-sided descending aorta. Ann Thorac Surg. 99(2):713, 2015
                                                                          14. Oya S et al: Oesophageal cancer with an aberrant right subclavian artery accompanied by a thoracic duct anomaly. Eur J Cardiothorac Surg. 48(3):e55-7, 2015
                                                                          15. Pieper CC et al: Direct cervical puncture for retrograde thoracic duct embolization in a postoperative cervical lymphatic fistula. J Vasc Interv Radiol. 26(9):1405-8, 2015
                                                                          16. Richards MK et al: A national review of the frequency of minimally invasive surgery among general surgery residents: assessment of ACGME case logs during 2 decades of general surgery resident training. JAMA Surg. 150(2):169-72, 2015
                                                                          17. Shirakawa Y et al: Prone-position thoracoscopic ligation of the thoracic duct for chyle leak following radical neck dissection in a patient with a right aortic arch. Acta Med Okayama. 69(3):173-6, 2015
                                                                          18. Veziant J et al: Lymphovenous anastomosis for recurrent swelling syndrome and chylous effusion due to cervical thoracic duct cyst. J Vasc Surg. 62(4):1068-70, 2015
                                                                          19. Ikeda Y: Thoracoscopic management of cervical thoracic duct injuries after thyroidectomy with lymphadenectomy. Asian J Endosc Surg. 7(1):82-4, 2014
                                                                          20. Kumar A et al: Primary cervical thoracic duct cyst: a case report and review of the literature. Ear Nose Throat J. 93(7):E17-21, 2014
                                                                          21. Nakano T et al: Three-dimensional imaging of a thoracic duct cyst before thoracoscopic surgery. Eur J Cardiothorac Surg. 45(3):585, 2014
                                                                          22. Ohnishi H et al: Life-threatening pulmonary lymphedema secondary to thoracic duct ligation. Intern Med. 53(20):2341-5, 2014
                                                                          23. Phang K et al: Review of thoracic duct anatomical variations and clinical implications. Clin Anat. 27(4):637-44, 2014
                                                                          24. W A Aziz WA et al: A unique approach to thoracic duct leak after esophagectomy. Surg Laparosc Endosc Percutan Tech. 24(4):e155-6, 2014
                                                                          25. Ladinsky HT et al: Thoracic duct injury resulting in abnormal newborn screen. J Allergy Clin Immunol Pract. 1(6):583-8, 2013
                                                                          26. Gill MT et al: Cervical thoracic duct cyst: Importance of preoperative suspicion for appropriate management of left-sided neck mass. Ear Nose Throat J. 91(12):E13-5, 2012
                                                                          27. Parker EE et al: MR imaging of the thoracic inlet. Magn Reson Imaging Clin N Am. 16(2):341-53, x, 2008
                                                                          28. Liu ME et al: Normal CT appearance of the distal thoracic duct. AJR Am J Roentgenol. 187(6):1615-20, 2006