Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly

We report a case of a patient who developed adult-onset plastic bronchitis (PB) due to aberrant lymphatic anatomy, which resulted in direct lymph drainage into the left lower lobe bronchus. After failure of medical management, successful thoracic duct embolization was performed targeting the aberran...

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Main Authors: Hayden L. Hofmann, BS, Jesse Han, BA, Jenanan Vairavamurthy, MD, Ramon R. Ter-Oganesyan, MD
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325006119
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author Hayden L. Hofmann, BS
Jesse Han, BA
Jenanan Vairavamurthy, MD
Ramon R. Ter-Oganesyan, MD
author_facet Hayden L. Hofmann, BS
Jesse Han, BA
Jenanan Vairavamurthy, MD
Ramon R. Ter-Oganesyan, MD
author_sort Hayden L. Hofmann, BS
collection DOAJ
description We report a case of a patient who developed adult-onset plastic bronchitis (PB) due to aberrant lymphatic anatomy, which resulted in direct lymph drainage into the left lower lobe bronchus. After failure of medical management, successful thoracic duct embolization was performed targeting the aberrant lymphatic duct via transnodal lymphangiography and a retrograde transvenous lymphatic access. Following intervention, the patient reported no adverse events and complete resolution of symptoms without any chronic cough or cast expectoration. The case supports the advantages of transcatheter lymphatic embolotherapy including its minimally invasive nature and short recovery period and hospital stay. Additionally, the case provides evidence for the use of transcatheter thoracic duct n-butyl cyanoacrylate (n-BCA) embolization for managing lymphatic malformations in patients presenting with plastic bronchitis.
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spelling doaj-art-1f6ed0f193e14ac79bc8395c0c3d38ac2025-08-20T03:24:59ZengElsevierRadiology Case Reports1930-04332025-10-0120104994499710.1016/j.radcr.2025.06.068Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomalyHayden L. Hofmann, BS0Jesse Han, BA1Jenanan Vairavamurthy, MD2Ramon R. Ter-Oganesyan, MD3Department of Radiology, Division of Interventional Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Corresponding author.Department of Radiology, Division of Interventional Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USADepartment of Radiology, Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USADepartment of Radiology, Division of Interventional Radiology, Los Angeles General Medical Center, Los Angeles, CA, USAWe report a case of a patient who developed adult-onset plastic bronchitis (PB) due to aberrant lymphatic anatomy, which resulted in direct lymph drainage into the left lower lobe bronchus. After failure of medical management, successful thoracic duct embolization was performed targeting the aberrant lymphatic duct via transnodal lymphangiography and a retrograde transvenous lymphatic access. Following intervention, the patient reported no adverse events and complete resolution of symptoms without any chronic cough or cast expectoration. The case supports the advantages of transcatheter lymphatic embolotherapy including its minimally invasive nature and short recovery period and hospital stay. Additionally, the case provides evidence for the use of transcatheter thoracic duct n-butyl cyanoacrylate (n-BCA) embolization for managing lymphatic malformations in patients presenting with plastic bronchitis.http://www.sciencedirect.com/science/article/pii/S1930043325006119Plastic bronchitisThoracic duct embolizationLymphatic malformations
spellingShingle Hayden L. Hofmann, BS
Jesse Han, BA
Jenanan Vairavamurthy, MD
Ramon R. Ter-Oganesyan, MD
Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly
Radiology Case Reports
Plastic bronchitis
Thoracic duct embolization
Lymphatic malformations
title Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly
title_full Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly
title_fullStr Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly
title_full_unstemmed Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly
title_short Retrograde thoracic duct embolization for adult-onset plastic bronchitis with idiopathic lymphatic flow anomaly
title_sort retrograde thoracic duct embolization for adult onset plastic bronchitis with idiopathic lymphatic flow anomaly
topic Plastic bronchitis
Thoracic duct embolization
Lymphatic malformations
url http://www.sciencedirect.com/science/article/pii/S1930043325006119
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AT jenananvairavamurthymd retrogradethoracicductembolizationforadultonsetplasticbronchitiswithidiopathiclymphaticflowanomaly
AT ramonrteroganesyanmd retrogradethoracicductembolizationforadultonsetplasticbronchitiswithidiopathiclymphaticflowanomaly