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Case 72 - Prominent cysterna chyli

Published online by Cambridge University Press:  07 October 2011

By
John Hildebrandt
Edited by
Thomas Hartman
Thomas Hartman
Affiliation:
Mayo Clinic, Rochester
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Summary

Imaging description

The cysterna chyli is a lymphatic sac formed by the confluence of lumbar lymphatic ducts. It is the origin (caudal-most aspect) of the thoracic duct [1]. It is in the right retrocrural space usually at the T11–L2 level [1]. The confluence of the lumbar lymphatic channels occasionally (1.7%) will form a distinct tubular structure on CT [2] and can appear as a round or elliptical opacity 4–9 mm (average 7 mm) in size [2]. On CT it has attenuation similar to that of water [1, 2] (Figure 72.1). On MRI it has signal intensity similar to that of bile or cerebrospinal fluid [3] and can have many different shapes including round, oval, sausage-shaped, or a focal plexus [3].

Importance

A prominent cysterna chyli can simulate a low-attenuation enlarged lymph node or focal retrocrural fluid collection.

Type
Chapter
Information
Pearls and Pitfalls in Thoracic Imaging
Variants and Other Difficult Diagnoses
 , pp. 192
Publisher: Cambridge University Press
Print publication year: 2011

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References

Gollub, MJCastellino, RA.The cisterna chyli: a potential mimic of retrocrural lymphadenopathy on CT scansRadiology 1996 199 477CrossRefGoogle ScholarPubMed
Smith, TRGrigoropoulos, J.The cisterna chyli: incidence and characteristics on CTClin Imaging 2002 26 18CrossRefGoogle ScholarPubMed
Pinto, PSSirlin, CBAndrade-Barreto, OACisterna chyli at routine abdominal MR imaging: a normal anatomic structure in the retrocrural spaceRadiographics 2004 24 809CrossRefGoogle ScholarPubMed

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