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chylous pleural effusion
Etiology:
1) thoracic duct trauma
2) tumor (lymphoma)
3) tuberculosis
4) tuberous sclerosis (lymphangiomyomatosis)
5) surgery
a) esophagectomy
b) cardiac surgery
6) other conditions
a) Kaposi's sarcoma with mediastinal adenopathy
b) Valsalva maneuver during childbirth
d) esophageal sclerotherapy
e) thromboses
1] superior vena cava
2] innominate vein
3] subclavian vein
7) cholesterol effusions
a) tuberculous effusions
b) rheumatoid effusions
c) nephrotic syndrome
Pathology:
1) true chylous effusions contain chylomicrons
2) cholesterol effusions are pseudochylous effusion
Clinical manifestations:
- dyspnea 57%
Laboratory: pleural fluid triglycerides > 100 mg/dL.
General
pleural effusion
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 772
- Doerr CH, Allen MS, Nichols FC 3rd, Ryu JH.
Etiology of chylothorax in 203 patients.
Mayo Clin Proc. 2005 Jul;80(7):867-70.
PMID: 16007891