Lymphoscintigraphy using Tc-99m human serum albumin in chylothorax

A 70-year-old woman with carcinoma of the right lung underwent resection of the right upper lobe and mediastinal lymph nodes. After surgery, a chest radiograph showed right pleural effusion and drained fluid was proved to be chylous. Lymphoscintigraphy using Tc-99m human serum albumin HSA was performed to evaluate the site of leakage. Normal passage through the lymphatic vessels was shown after subcutaneous injection into the right hand. The radiotracer was administered into both feet the next day, and leakage to the right pulmonary apex was shown, which indicates a disruption of the thoracic duct in the superior mediastinum.