Post-traumatic cervical chyloma

by Juan Gomez, MD, Enrique Palacios, MD, FACR, and Jagan D. Gupta, MD | Tuesday, January 01, 2008

Chylomas are cysts or pseudocysts that arise from the thoracic duct and its tributaries. Chylomas can be either congenital or acquired.1,2 Acquired chylomas can result from thoracic surgery, radical neck dissection, blunt or penetrating trauma, or tumor erosion, or they can occur secondary to subclavian vein line placement.2,3The thoracic duct is the common trunk where most of the lymphatic channels drain, and its unique anatomy predisposes it to trauma.2,4 The thoracic duct congregates most of the chyle and lymph from the blood. Macroscopically, chyle appears as a turbid, milky fluid composed of emulsified fat, triglycerides, proteins, glucose, electrolytes, antithrombin globulin, prothrombin, and fibrinogen, as well as cellular components such as lymphocytes and erythrocytes.2,4The thoracic duct extends from the cisterna chyli, at the level of the second lumbar vertebral body, to a structure posterior and to the right of the aorta.1,2 From the cisterna chyli, it ascends into the .../continued/

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