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Objective <p>Chyloptysis indicates the presence of a lymphangio-bronchial fistula. This study compared the chest CT imaging features and clinical manifestations between CLA (complex lymphatic anomalies) patients with and without chyloptysis.</p> Materials and methods <p>A retrospective analysis was performed on 291 thoracic CLA patients (142 males, 149 females) admitted from December 2008 to February 2024. Divided into chyloptysis (152) and non—chyloptysis (139) groups, we compared their clinical data and chest CT features to find differences related to chyloptysis in CLA patients.</p> Results <p>The chyloptysis group had a significantly higher incidence of chyle pericardium, as well as more cystic lesions at the right lymphatic duct, and of the thoracic duct itself. In contrast, the non-chyloptysis group showed more cystic lesions of the liver, spleen, abdominal cavity, neck, and skeleton. All these differences were statistically significant (<i>P</i> &lt; 0.05).The incidence of lymphedema in the non-chyloptysis group was higher than that in the chyloptysis group (<i>P</i> &lt; 0.05), among which there was a significant statistical correlation between lymphedema of the lower limbs, lymphedema of the scrotum, lymphedema of the face and lymphedema of the upper limbs and chyloptysis (<i>P</i> &lt; 0.05). The severity of chylopulmonary disease was closely related to the appearance of chyloptysis (<i>P</i> &lt; 0.001). In terms of the characteristics of chest CT findings, the incidence of GGO, consolidation, grid shadow, vacuolar sign, nodular pleural thickening, solid nodules, perifascicular interstitial thickening, hilar opacity or swelling, and parapericardial effusion were higher in the chyloptysis group than in the non-chyloptysis group (<i>P</i> &lt; 0.05).</p> Conclusion <p>The analysis of these differences is of great clinical significance for understanding the distribution of chyloptysis in CLA patients with different CT signs, and it is convenient for clinicians to strengthen the risk prediction and management of chyloptysis in CLA patients.</p>

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Comparative analysis of clinical and CT manifestations between complex lymphatic anomalies with and without chyloptysis

  • 期刊论文

  • 发表日期：

    2025年10月30日

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  • Mingxia Zhang,
  • Ling Li,
  • Ying Sun,
  • Meng Huo,
  • Chunyan Zhang,
  • Lei Sun,
  • Rengui Wang,
  • Yunlong Yue

摘要

Objective

Chyloptysis indicates the presence of a lymphangio-bronchial fistula. This study compared the chest CT imaging features and clinical manifestations between CLA (complex lymphatic anomalies) patients with and without chyloptysis.

Materials and methods

A retrospective analysis was performed on 291 thoracic CLA patients (142 males, 149 females) admitted from December 2008 to February 2024. Divided into chyloptysis (152) and non—chyloptysis (139) groups, we compared their clinical data and chest CT features to find differences related to chyloptysis in CLA patients.

Results

The chyloptysis group had a significantly higher incidence of chyle pericardium, as well as more cystic lesions at the right lymphatic duct, and of the thoracic duct itself. In contrast, the non-chyloptysis group showed more cystic lesions of the liver, spleen, abdominal cavity, neck, and skeleton. All these differences were statistically significant (P < 0.05).The incidence of lymphedema in the non-chyloptysis group was higher than that in the chyloptysis group (P < 0.05), among which there was a significant statistical correlation between lymphedema of the lower limbs, lymphedema of the scrotum, lymphedema of the face and lymphedema of the upper limbs and chyloptysis (P < 0.05). The severity of chylopulmonary disease was closely related to the appearance of chyloptysis (P < 0.001). In terms of the characteristics of chest CT findings, the incidence of GGO, consolidation, grid shadow, vacuolar sign, nodular pleural thickening, solid nodules, perifascicular interstitial thickening, hilar opacity or swelling, and parapericardial effusion were higher in the chyloptysis group than in the non-chyloptysis group (P < 0.05).

Conclusion

The analysis of these differences is of great clinical significance for understanding the distribution of chyloptysis in CLA patients with different CT signs, and it is convenient for clinicians to strengthen the risk prediction and management of chyloptysis in CLA patients.