{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T08:54:33Z","timestamp":1772268873205,"version":"3.50.1"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,12]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Lymphatic dysfunction can manifest through a spectrum of clinical features, including lower limb lymphoedema and pulmonary complications such as recurrent pleural effusions. Diagnosing underlying lymphatic abnormalities remains challenging due to nonspecific symptoms and limited imaging options. This case study describes a man hospitalised for a left-sided pneumothorax followed by recurrent pleural effusions and peripheral oedema. Using non-contrast MR lymphangiography and near-infrared fluorescence imaging, lymphatic vessel abnormalities were visualised in the extremities. Imaging also revealed thoracic lymphangiectasia and dilated lymphatic vessels, resembling abnormalities observed in patients with a Fontan circulation who experience pleural effusions. This combined imaging approach shows promise for evaluating complex lymphatic phenotypes and may enable more personalised treatment strategies for patients with these symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2025-265897","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:05:14Z","timestamp":1772255114000},"page":"e265897","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lymphatic phenotype characterisation by MR lymphangiography and near-infrared fluorescence imaging in a patient with pleural effusions and oedema"],"prefix":"10.1136","volume":"19","author":[{"given":"Maja","family":"Cehov","sequence":"first","affiliation":[{"name":"Department of Radiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inger Norlyk","family":"Sheyanth","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4368-2246","authenticated-orcid":false,"given":"Sheyanth","family":"Mohanakumar","sequence":"additional","affiliation":[{"name":"Department of Radiology, Aarhus University Hospital, Aarhus, Denmark"},{"name":"AURA, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022721050455000_19.2.e265897.1","doi-asserted-by":"crossref","unstructured":"Negm AS , Collins JD , Bendel EC , et al . MR Lymphangiography in Lymphatic Disorders: Clinical Applications, Institutional Experience, and Practice Development. Radiographics 2024;44. doi:10.1148\/rg.230075","DOI":"10.1148\/rg.230075"},{"key":"2026022721050455000_19.2.e265897.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.2010.01394.x"},{"key":"2026022721050455000_19.2.e265897.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(00)00727-0"},{"key":"2026022721050455000_19.2.e265897.4","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ccm.2016.04.004","article-title":"Nonmalignant Adult Thoracic Lymphatic Disorders","volume":"37","author":"Itkin","year":"2016","journal-title":"Clin Chest Med"},{"key":"2026022721050455000_19.2.e265897.5","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.118.008074","article-title":"Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation","volume":"12","author":"Mohanakumar","year":"2019","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026022721050455000_19.2.e265897.6","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1148\/radiol.2019180877","article-title":"MRI Evaluation of Lymphatic Abnormalities in the Neck and Thorax after Fontan Surgery: Relationship with Outcome","volume":"291","author":"Biko","year":"2019","journal-title":"Radiology"},{"key":"2026022721050455000_19.2.e265897.7","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000004507","article-title":"Lymphatic Function Decreases over Time in the Arms of Breast Cancer Patients following Treatment","volume":"10","author":"Johannessen","year":"2022","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026022721050455000_19.2.e265897.8","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000003779","article-title":"Lymphatic Function in the Arms of Breast Cancer Patients-A Prospective Cohort Study","volume":"9","author":"Alstrup","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026022721050455000_19.2.e265897.9","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1089\/lrb.2019.0028","article-title":"Reduced Lymphatic Function Predisposes to Calcium Channel Blocker Edema: A Randomized Placebo-Controlled Clinical Trial","volume":"18","author":"Mohanakumar","year":"2020","journal-title":"Lymphat Res Biol"},{"key":"2026022721050455000_19.2.e265897.10","doi-asserted-by":"crossref","DOI":"10.1148\/ryct.230315","article-title":"Sequential MRI Evaluation of Lymphatic Abnormalities over the Course of Fontan Completion","volume":"6","author":"Kelly","year":"2024","journal-title":"Radiol Cardiothorac Imaging"},{"key":"2026022721050455000_19.2.e265897.11","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11797"},{"key":"2026022721050455000_19.2.e265897.12","doi-asserted-by":"crossref","first-page":"340","DOI":"10.23876\/j.krcp.22.062","article-title":"Body water percentage from childhood to old age","volume":"42","author":"Lu","year":"2023","journal-title":"Kidney Res Clin Pract"},{"key":"2026022721050455000_19.2.e265897.13","doi-asserted-by":"crossref","unstructured":"Shimanuki Y , Miyoshi S , Anzai N , et al . Utility of contrast-enhanced magnetic resonance lymphangiography for yellow nail syndrome with lymphangiopathy: a case report. Oxf Med Case Reports 2022;2022. doi:10.1093\/omcr\/omac077","DOI":"10.1093\/omcr\/omac077"},{"key":"2026022721050455000_19.2.e265897.14","first-page":"1554","article-title":"Nonenhanced MR Lymphography","volume":"40","author":"Cholet","year":"2020","journal-title":"Radiographics Radiological Society of North America"},{"key":"2026022721050455000_19.2.e265897.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.02.013"},{"key":"2026022721050455000_19.2.e265897.16","doi-asserted-by":"publisher","DOI":"10.1159\/000323484"},{"key":"2026022721050455000_19.2.e265897.17","doi-asserted-by":"crossref","unstructured":"Gordon K , Moore M , Van Zanten M , et al . Case Report: Progressive central conducting lymphatic abnormalities in the RASopathies. Two case reports, including successful treatment by MEK inhibition. Front Genet 2022;13. doi:10.3389\/fgene.2022.1001105","DOI":"10.3389\/fgene.2022.1001105"},{"key":"2026022721050455000_19.2.e265897.18","doi-asserted-by":"crossref","unstructured":"Kleimeier LER , van Schaik C , Leenders E , et al . Lymphatic Phenotype of Noonan Syndrome: Innovative Diagnosis and Possible Implications for Therapy. J Clin Med 2022;11. doi:10.3390\/jcm11113128","DOI":"10.3390\/jcm11113128"},{"key":"2026022721050455000_19.2.e265897.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2013.09.004"},{"key":"2026022721050455000_19.2.e265897.20","doi-asserted-by":"crossref","unstructured":"Sheppard SE , March ME , Seiler C , et al . Lymphatic disorders caused by mosaic, activating KRAS variants respond to MEK inhibition. JCI Insight 2023;8. doi:10.1172\/jci.insight.155888","DOI":"10.1172\/jci.insight.155888"},{"key":"2026022721050455000_19.2.e265897.21","doi-asserted-by":"crossref","unstructured":"Smith CL , Krishnamurthy G , Srinivasan A , et al . Lymphatic interventions in congenital heart disease. Semin Pediatr Surg 2024;33. doi:10.1016\/j.sempedsurg.2024.151419","DOI":"10.1016\/j.sempedsurg.2024.151419"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265897","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:05:17Z","timestamp":1772255117000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-265897"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265897","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}