Systematic lymphatic abnormality-related osseous lesions: a study based on CT lymphangiography

BACKGROUND: Few studies have focused on the morphology of systematic lymphatic abnormality-related osseous lesions. In this study, we classified systematic lymphatic abnormality-related osseous lesions into four types based on their morphology and density. We also discussed the imaging features of computed tomography lymphangiography (CTL) in this disease. METHODS: In this retrospective cohort study, the clinical and imaging data of 39 patients with systematic lymphatic abnormality-related osseous lesions were collected. All patients underwent computed tomography (CT) scans of the chest and abdomen after direct lymphangiography, and two experienced radiologists evaluated the CTL features of intraosseous and extraosseous lymphatic vessel abnormalities. RESULTS: Intraosseous osteolytic changes were observed in all 39 patients. According to the morphological density of the lesions, systematic lymphatic abnormality-related osseous lesions were classified into four types: cyst-like (76.9%), canal-like or honeycomb-like (87.2%), osteoporosis-like (41.0%), and osteosclerosis-like (20.5%), with abnormal deposits of lipiodol seen in the first two types. Enhanced CT of the thorax and abdomen was performed in 11 cases, and enhancement was not seen in any intraosseous lesions. CONCLUSIONS: The CTL features of systematic lymphatic abnormality-related osseous lesions have specific characteristics and are often accompanied by extraosseous abnormalities, which can provide a vital imaging basis for the diagnosis and differentiation of this disease.