LYMPHATIC DISEASES IN INTERVENTIONAL RADIOLOGY – breaking the toughest tortoise shell

Interventional Management of Lymphatic DisordersLymphatic abnormalities range from isolated malformations to complex system-wide abnormalities and lymphedema. The Central Conducting Lymphatics (CCL), comprised of the lumbar trunks, cisterna chyli, and thoracic duct, handle a daily flow of 8–12 L of interstitial fluid, with significant contributions from hepatic (50%) and mesenteric (40%) sources. Diagnosis is facilitated by functional imaging, such as Intranodal Dynamic Contrast-Enhanced MR Lymphangiography (DCEMRL) and the more rapid Intranodal CT Lymphangiography (INCTL). Management strategies are categorized by the SEOAS system (Symptoms, Etiology, Origin, Anatomy, Syndromic), utilizing sclerotherapy or embolization (e.g., Thoracic Duct Embolization) to treat leaks such as chylothorax, chylous ascites, and lymphoceles.