Clinical and CT imaging features of different types of thoracic complex lymphatic anomaly.

BACKGROUND

Complex lymphatic anomaly is a type of lymphatic malformation involving multiple organs and systems, and its clinical and imaging manifestations are varied. The aim of this study was to retrospectively analyze the clinical and imaging features of conventional computed tomography (CT) and CT lymphangiography in patients with thoracic complex lymphatic anomaly. Further, we aimed to explore the imaging features and differences among different subtypes of thoracic complex lymphatic anomaly (generalized lymphatic anomaly, Gorham-Stout disease, central conducting lymphatic anomaly).

METHODS

This study enrolled 119 patients with thoracic complex lymphatic anomaly in Beijing Shijitan Hospital, Capital Medical University (Peking University Ninth School of Clinical Medicine) from January 2017 to December 2020. The differences in gender, symptoms, lesion location, lesion morphology, and abnormal deposition of lipiodol among the three types of thoracic complex lymphatic anomaly were compared. Chi-square test or Fisher's exact test was used, and Bonferroni test was used for pairwise comparison.

RESULTS

Among the 119 patients with thoracic complex lymphatic anomaly, 67 patients had generalized lymphatic anomaly, 21 patients had Gorham-Stout disease, and 31 patients had central conducting lymphatic anomaly. There were significant differences in the age (P=0.005), limb swelling (P=0.009), diarrhea (P<0.001), involvement of lung (P=0.004), mediastinum (P=0.026), abdominopelvic wall (P=0.014), spleen (P=0.020), bone (P<0.001), cystic lesions (P=0.001), and diffuse swelling lesions (P=0.023) among the three groups. Abnormal deposition of lipiodol was most common at the end of the thoracic duct.

CONCLUSIONS

The different types of thoracic complex lymphatic anomaly have different clinical and imaging manifestations. Conventional chest CT and CT lymphangiography can provide imaging information for the diagnosis of different types of patients, which is conducive to accurate diagnosis and treatment.