• Takao Minakata, Takashi Suzuki, Yoshito Kamio, Mitsutaka Kadokura, Naoya Himuro, and Hidefumi Takei.
• Division of Chest Surgery, Department of Surgery, Showa University Hospital, Tokyo, Japan.
• Chest. 2020 Nov 1; 158 (5): e221-e224.

AbstractA 40-year-old woman with lymphangiomatosis also had an intrathoracic lymphangioma infection. Since the age of 8 years, the patient had undergone repeated abdominal and mediastinal cyst surgeries and had received a diagnosis of lymphangiomatosis. At this time, she showed a high fever of 38.5°C. Cultures of both blood and fluid aspirated from the cyst were positive for Staphylococcus aureus. Chest CT imaging revealed an enlarged right-sided mediastinal cystic lymphangioma with new septa in it. A chest tube was inserted into the cyst to remove effusion. The patient was then started with the antibacterial drug cefazolin at 3 g/d. But effective drainage was difficult because of the high viscosity of the effusion and septa working as barriers. We removed these components with endoscopic surgical instruments and via a pulsed-lavage system under general anesthesia. Postoperative CT images showed reexpanded lung structure and reduced cyst size. The patient has taken a favorable course for 2 years.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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