PMC5051666_01
The clinical photograph of the patient: (a) the patient had 5 cm subcutaneous mass in her right thigh and (b) the site where the mass located formed depression after puncture and drainage of the content fluid.
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At the first consultation, we found a subcutaneous mass which was 5 cm in diameter (Figure 1(a)). Although the site where the mass had located formed depression after puncture (Figure 1(b)), it reoccurred in a few days.
The findings of indocyanine green (ICG) lymphography and the clinical photograph. Red circle: injection site of ICG (a) linear pattern can be seen in the dorsum of the foot, which indicates normal lymphatic function; (b) dermal backflow is observed around the knee and the subcutaneous mass (arrow), which means there is lymphatic dysfunction in this area; (c) collateral lymphatic vessels are developed around the subcutaneous mass (arrows); and (d) clinical photograph of the same site as (c).
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Although we observed normal linear pattern from dorsum of the foot to the middle of the lower leg, stardust pattern, a kind of dermal backflow, was found around the mass, which indicated lymphatic dysfunction (Figure 2).
The findings of indocyanine green (ICG) lymphography with color mapping mode: (a) green, blue, pink, and red colors indicate the existence and the relative concentration of ICG. Green color indicates lower concentration, and red color indicates higher concentration; (b) photograph of the drained yellow fluid; and (c) the drained fluid presents green color, which indicates the existence of ICG leaking from the lymphatic system.
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The fluid was contrasted with ICG during the examination, and the involvement of the lymphatic system was proven (Figure 3).