Pleural Fluid Characteristics of Chylothorax

Maldonado, Fabien; Hawkins, Finn J.; Daniels, Craig E.; Doerr, Clinton H.; Decker, Paul A.; Ryu, Jay H.
February 2009
Mayo Clinic Proceedings;Feb2009, Vol. 84 Issue 2, p129
Academic Journal
OBJECTIVE: To determine the biochemical parameters of chylous pleural fluids and better inform current clinical practice in the diagnosis of chylothorax. PATIENTS AND METHODS: We retrospectively reviewed 74 patients with chylothorax (defined by the presence of chylomicrons) who underwent evaluation during a 10-year period from January 1, 1997, through December 31, 2006. The biochemical parameters and appearance of the fluid assessed during diagnostic evaluation were analyzed. RESULTS: The study consisted of 37 men (50%) and 37 women (50%), with a median age of 61.5 years (range, 20-93 years). Chylothorax was caused by surgical procedures in 51%. The chylous pleural fluid appeared milky in only 44%. Pieural effusion was exudative in 64 patients (86%) and transudative in 10 patients (14%). However, pieural fluid protein and lactate dehydrogenase ieveis varied widely. Transudative chylothorax was present in all 4 patients with cirrhosis but was also seen with other causes. The mean ± SD triglyceride level was 728±797 mg/dL, and the mean ± SD cholesterol value was 66±30 mg/dL. The pleural fluid triglyceride value was less than 110 mg/dL In 10 patients (14%) with chylothorax, 2 of whom had a triglyceride value lower than 50 mg/dL. CONCLUSION: Chylothoraces may present with variable pleural fluid appearance and biochemical characteristics. Nonmilky appearance is common. Chylous effusions can be transudative, most commonly in patients with cirrhosis. Traditional triglyceride cutoff values used In excluding the presence of chylothorax may miss the diagnosis In fasting patients, particularly in the postoperative state.


Related Articles

  • PLEURAL EFFUSION OF CIRRHOTIC ORIGIN: PATHOGENESIS, CLINICAL PRESENTATION AND DIAGNOSIS. Niculescu, Zizi; Ghinea, Mihaela Maria; Niculescu, Costin; Grigorian, Mircea; Caraiane, Aureliana // International Multidisciplinary Scientific Conference on Social ;2014, p681 

    Background Hepatic hydrothorax is defined as a significant pleural effusion (usually greater than 500 ml) in a cirrhotic patient, without an underlying pulmonary or cardiac disease. The incidence of hepatic hydrothorax varies from 0.4% to 10% according to different reports, and it occurs much...

  • The Occurrence Of Pleural Effusion Secondary To Ovarian Fibroma. Kant, Surya; Verma, Sanjay Kumar; Verma, Rajendra // Internet Journal of Pulmonary Medicine;2009, Vol. 10 Issue 2, p7 

    The association of pleural effusion and ascitis, secondary to ovarian tumor, are considered to be uncommon clinical condition. Hereby we reported a case of 43 years old female presented as right sided pleural effusion and ascitis secondary to ovarian fibroma and after removal of ovarian tumor...

  • Pleural effusion - An unusual cause. Vinoth, Ponnurangam Nagarajan; Anitha, Palaniyadi; Muthamilselvan, Sathyamoorthi; Sasitharan, Rajendraprasath; Shuba, Sankaranarayan; Rajakumar, Padur Sivaraman; Scott, Julius Xavier // Australasian Medical Journal;2012, Vol. 5 Issue 7, p113 

    Hepatitis A (HAV) infection is one of the most common forms of hepatitis in the paediatric age group in developing countries. It is usually self-limiting and rarely accompanied by extra hepatic complication. In this article, we report two children with hepatitis A who had associated issues of...

  • Supradiaphragmatic thoracic duct clipping for chylothorax through left-sided video-assisted thoracoscopic surgery. Watanabe, Atsushi; Koyanagi, Tetsuya; Nakashima, Shinji; Higami, Tetsuya // European Journal of Cardio-Thoracic Surgery;Feb2007, Vol. 31 Issue 2, p313 

    Abstract: Chylothorax is a life-threatening clinical entity. Traditional surgical management for cases refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy or closure of the site of duct laceration through an open thoracotomy. We report herein two...

  • Neonatal Pleural Effusion. Kallanagowdar, Chandra; Craver, Randall D. // Archives of Pathology & Laboratory Medicine;Feb2006, Vol. 130 Issue 2, pe22 

    Microscopic evaluation of a congenital left-sided chylothorax in a 33-week premature infant girl with trisomy 21 demonstrated lymphoid cells with features typical of lymphoblasts. Flow cytometry demonstrated a nonclonal mixture of mature and immature T cells. Because cellular morphology of...

  • Diffusion-weighted MR imaging of pleural fluid: differentiation of transudative vs exudative pleural effusions. Baysal, T.; Bulut, T.; Gökirmak, M.; Kalkan, S.; Dusak, A.; Dogan, M.; Gökirmak, M // European Radiology;May2004, Vol. 14 Issue 5, p890 

    The aim of this study was to evaluate the ability of diffusion-weighted MRI in differentiating transudative from exudative pleural effusions. Fifty-seven patients with pleural effusion were studied. Diffusion-weighted imaging (DWI) was performed with an echo-planar imaging (EPI) sequence (b...

  • Nontraumatic chylothorax: Revisited. Banerjee, Debasish B. // Journal of Indian Association of Pediatric Surgeons;Apr-Jun2007, Vol. 12 Issue 2, p96 

    A 2-month-old girl came with breathlessness of 5 days. duration. Clinical examination and plain chest radiograph showed it to be pleural effusion. On sonographically guided aspiration, the effusion fluid was found to be chyle. Introduction of intercostal thoracic drainage tube and antibiotics...

  • pleurorrhea.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1807 

    A definition of the medical term "pleurorrhea," which refers to effusion of fluid into the pleura, is presented.

  • Pleural Effusion from Malignancy. Leff, Alan; Hopewell, Philip C.; Costello, John // Annals of Internal Medicine;Apr78, Vol. 88 Issue 4, p532 

    Provides information on pleural effusion from metastatic malignancy. Dynamics of pleural-fluid formation; Characteristics of malignant effusion; Diagnosis of metastatic pleural malignancy; Details on the methods of treatment of recurrent effusion; Conclusions and recommendations.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics