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

## TL;DR

A patient with adult-onset plastic bronchitis due to abnormal lymphatic anatomy was successfully treated with a minimally invasive thoracic duct embolization procedure.

## Contribution

The paper presents a novel retrograde transvenous approach for thoracic duct embolization in treating lymphatic malformations causing plastic bronchitis.

## Key findings

- The patient experienced complete resolution of symptoms after the embolization procedure.
- The intervention was minimally invasive with no adverse events and a short recovery period.
- The case supports the use of n-BCA embolization for managing lymphatic malformations in plastic bronchitis.

## Abstract

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.