#Dr iftikar kullo professional

Methods: The radiotracer was administered with solid (in three healthy persons and one patient) or liquid meals (in three other healthy persons). Purpose: To investigate the use of orally administered iodine-123–labeled 15-(4-iodophenyl)-3(R,S)-methyl-pentadecanoic acid (I-123 BMIPP) for thoracic duct imaging in normal and pathologic states and to study the tracer distribution and dynamics in healthy participants. The logistics of modern imaging technologies makes it possible to successfully diagnose such a rare disease as CMTLD already at the stage of the patient’s initial visit to the doctor. In older patients, acquired and asymptomatic CMTLD are most often diagnosed. CMTLD – congenital lymphatic anomalies, more frequent and symptomatic in children. The revealed X-ray and pathoanatomical changes were compared.Ĭonclusion. The nature (X-ray semiotics) of preoperative imaging using computed tomography has been clarified.

We present the own clinical and radiological observation of a 26-year-old patient without any special clinical manifestations, in whom volumetric changes in the mediastinum on the left were detected during routine fluorography.

#Dr iftikar kullo professional

Effective non-invasive diagnostics at the initial visit of the patient already at the outpatient stage deserves professional evaluation. The median prevalence is less than 1 % among all mediastinal cystic formations. CMTLD – benign, extremely rare lymphovascular lesions resulting from embryological disorders (weakness of the duct wall and valve mechanism) in the development of the lymphatic system.

According to the generally accepted classification of vascular formations ISSVA (adopted at the 20th ISSVA conference in Melbourne in April 2014, last revised in May 2018), the term “lymphangioma” with regard to lymphatic malformations is considered obsolete, its use is recommended for true benign tumors of the lymphatic vessels. In the literature, the pathology of the thoracic lymphatic duct is designated by two terms: “lymphangioma” and “cystic malformation of the thoracic lymphatic duct”. Demonstration of modern possibilities of clinical and radiological diagnosis of cystic malformation of the thoracic lymphatic duct (CMTLD). Therefore, the left-sided localization of the revealed pathological changes, with the involvement of the mediastinum and neck in the process at the same time, can be a sign of damage to the thoracic lymphatic duct (at the location), and therefore the key to a successful diagnosis of the disease.Īim. The thoracic lymphatic duct in the upper half of the body collects lymph from the left lung, the left half of the heart, the walls of the left half of the chest, from the left upper limb and the left half of the neck and head. Note the mass lesions adherent to the walls of the main pulmonary artery (arrows) and extending from the right ventricular cavity and the tricuspid bioprosthesis. Bottom right, D : Long-axis view of the main pulmonary artery (MPA). The tumor in the pulmonary artery was attached to the tricuspid bioprosthesis and extended into the pulmonary outflow tract. The tumor in the superior vena cava originated from the azygos vein and prolapsed into the right atrium.

Note the tumor within the superior vena cava (SVC) and the pulmonary artery (PA). Bottom left, C : Short-axis scan at the base of the heart with the transducer adjacent to the posteriorly located left atrium. The azygos vein is filled with tumor mass. Top right, B : Long-axis view of the descending thoracic aorta (Ao) and the azygos vein (arrows) running parallel to the surface of the thoracic aorta. The tumor extends out the right ventricular outflow tract. The right atrial cavity is nearly filled by multiple fronds of the tumor extending through and attached to the PV (arrow). Top left, A : Transgastric long-axis view of the right ventricle (RV) and bioprosthetic tricuspid valve (PV, arrowheads ). Transesophageal echocardiographic features of intracardiac leiomyomatosis in case 2.