Cysts Originating from Cervical Lymphatic Ducts
Authors:
Z. Pokorná 1; I. Stárek 1; Richard Salzman 1
; D. Skanderová 2
; P. Flodr 2
Authors‘ workplace:
Klinika otorinolaryngologie a chirurgie hlavy a krku FN Olomouc
1; Ústav klinické a molekulární patologie LF UP a FN Olomouc
2
Published in:
Otorinolaryngol Foniatr, 67, 2018, No. 2, pp. 71-76.
Category:
Review Article
Overview
Cysts originating from cervical lymphatic ducts are very seldom affections. However, they play an important role in the differential diagnosis of supraclavicular masses. The etiology remains unclear. Practically all cases arise from the thoracic duct, those affecting the right lymphatic duct are encountered exceptionally rarely. The cysts manifest themselves clinically as an otherwise asymptomatic swelling in the supraclavicular area. The diagnostics is based on imaging methods. However, both the CT and MRI scans lack any specific feature. In some cases, a direct communication between the cyst and relevant duct can be demonstrated using a lymphangiography. In a lab analysis, high content of T lymphocytes and triglyceride level is pathognomonic. In the differential diagnosis of these cyst the main problem is posed by so called unilocular lymphatic cysts, which share practically identical histomorphology, but they lack communication with a lymphatic duct. There is not a uniform opinion on the therapy. Because of absolute benign nature and possibility of spontaneous regression of these cysts, wait and see strategy is an option. A successful sclerotization was reported. The majority of authors prefer surgical exstirpation. At the operation, lymphatic vessels entering the cyst must be ligated to prevent the chyle leakage. In the presented overview, etiological, pathomorphological and clinical aspects of the cervical lymphatic duct cysts are described in detail.
Keywords:
thoracic duct, right cervical duct, cyst, differential diagnosis
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