Thoracic duct cyst: A case report and review of 29 cases

Cysts of the thoracic duct are rare. We report a case of a cervical thoraci c duct cyst and review 29 thoracic duct cysts reported previously (19 media stinal, 9 cervical, and 1 abdominal). The mean age of the patients was 47.6 years (range 17 to 86 years). Fourteen (46.7%) of the patients were asympt omatic. When symptoms were present, they ranged from retrosternal pain, dys phagia, and dyspnea to respiratory insufficiency and superior vena cava com pression. Diagnosis of the cyst can be made after computed tomography or ul trasonography. The cystic fluid contains T lymphocytes and triglycerides in excess. The symptoms in a patient with a thoracic duct cyst are related to compression of adjacent structures. The most profound symptoms are likely to be produced by mediastinal cysts above the aortic arch. Treatment consis ts of surgical removal of the cyst and ligation of all lymphatics connected to the cyst.