Fig. 3From: The spectrum of imaging manifestations of Gorham–Stout disease: a novel dynamic contrast-enhanced MR lymphangiography A 31-year-old male with Gorham–Stout disease. A 31-year-old man diagnosed with Gorham‒Stout disease presented with dyspnea related to massive chylous pleural effusion on the right side. Dynamic contrast-enhanced magnetic lymphangiography (DCMRL) consisted of axial T2-weighted image (T2WI), axial/coronal contrast-enhanced T1-weighted image (T1WI), and maximum intensity projection (MIP) reconstruction images. A T2WI (first column) and contrast-enhanced T1WI (second column) reveal multiple bundles of hypertrophied lymphatic vessels with a dark signal in the thickened right posterior parietal pleura and contrasting bright signals (arrowheads), and there is a contrast-enhancing vertebral lesion (arrows). Contrast CT (third and fourth columns) showed osteolytic changes (arrow) and retroperitoneal soft-tissue lesions (arrowheads). B MIP images (first and second columns) showing extensive collateral lymphatic vascular channels in the retroperitoneal space (arrows) and a faint giant thoracic duct (arrowheads). C A faintly filled, large abnormal thoracic duct is visible on the coronal T1WI before MIP reconstruction (first column, arrowheads). The giant thoracic duct is confirmed using digital subtraction angiography (second column, arrowheads). D After thoracic duct embolization (first column, arrowheads), the right pleural effusion was controlled, but uncontrolled ascites developed (second column, arrows), and the patient returned to the hospital one year later. When DCMRL was performed again, lymphatic flow (third and fourth columns, arrows) in the abdominal cavity was enriched, which was thought to have occurred because of the blocked outletBack to article page