E1782. Anatomy and Pathology of the Lymphatic System in the Chest and Abdomen: No Man's Land or Every Man's Land?
  1. Yun Song Choo; National University Hospital
The lymphatic system is complex and highly variable with lymphatic abnormalities encompassing a wide range of congenital and acquired disorders. Given that it transcends multiple compartmental spaces, referrals for suspected lymphatic disorders can span across multiple specialties. The lymphatic system can be occasionally overlooked on imaging due to small vessel size and variable anatomy. There is a renewed interest in imaging the lymphatic system due to increasing prevalence of radiological interventions that may be performed for lymphatic disorders. In this education exhibit, we revisit the anatomy of the lymphatic system in the chest and abdomen as well as common techniques used in imaging the lymphatic system and share illustrative cases demonstrating common lymphatic disorders that may be encountered in daily practice.

Educational Goals / Teaching Points
Some of the major teaching points are multiple imaging modalities may be considered for the evaluation of lymphatic abnormalities, including MRI and conventional lymphography. Lymphatic abnormalities commonly present as chylous effusions (such as pleural effusion or ascites) or cystic masses/collections. Iatrogenic chyle leak is one of the commonest acquired disorder of the lymphatic system, which can be evaluated with lymphographic techniques.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The anatomy of the lymphatic system in the chest and abdomen is highly variable and awareness of potential variants is helpful in diagnosing lymphatic disorders. Considerations while determining choice of imaging technique should include whether a focal cystic mass or collection is the target of evaluation or whether there is suspected chyle leak/altered lymph flow.

Imaging plays an increasingly important role in the depiction of the anatomy and pathology of the highly variable lymphatic system. It is important for radiologists to be aware of the potential variants and disorders as well as their imaging appearances.