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Nov 2011

Recurrent Lymphangiectasia of the Left Supraclavicular Fossa: An Unusual Cause of Paroxystic Swelling

Author Affiliations

Author Affiliations: Department of Internal Medicine, Hospices Civils de Lyon, H ôpital de la Croix-Rousse and University Claude Bernard Lyon, Lyon, France (Drs Varron, Green, Broussolle, and Seve); Department of Lymphology, Centre national de r éf érence des maladies vasculaires rares, H ôpital Cognac-Jay, Paris, France (Dr Vignes); and Department of Nuclear Medicine, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud and University Claude Bernard, Lyon, France (Dr Morelec).

Arch Dermatol. 2011;147(11):1337-1338. doi:10.1001/archdermatol.2011.306

A 64-year-old white woman had painless swelling of the left supraclavicular fossa extending to the side of the neck (Figure 1). She also had abdominal pain. She reported that the same symptoms had previously occurred 3 times over the course of 25 years and had always spontaneously resolved within 3 days. Duplex ultrasonography and computed tomography scans showed diffuse infiltration of the subcutaneous tissue of the left supraclavicular fossa and diffuse edema in the retroperitoneal area. The supraclavicular mass was punctured, producing a chylous fluid. Lymphoscintigraphy demonstrated abnormal lymphatic drainage with trace extravasation into the left infraclavicular fossa, suggesting obstruction of the cervical portion of the thoracic duct (Figure 2).

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