Pseudochylothorax: An unusual mode of revelation of pleural metastasis from solid tumor

Tumori
Arthur StreitStéphane Renaud

Abstract

Pseudochylothorax is a rare cause of pleural effusion. Sometimes confounded with chylothorax, firm diagnosis relies on analysis of the pleural liquid: exudative liquid (protein >30 g/L, lactate dehydrogenase >200 UI/L) with a high level of cholesterol (usually >200 mg/dL), low level of triglyceride (usually <110 mg/dL), cholesterol total/triglyceride ratio >1, absence of chylomicron, and in some cases the presence of cholesterol crystals. Pseudochylothorax is secondary to tuberculosis and rheumatoid arthritis in nearly 90% of cases. Its oncologic etiologies are mainly represented by malignant hematologic disorders. We report the first case of pseudochylothorax whose cause was the pleural metastasis of an extrathoracic solid tumor in a 61-year-old man with a medical history of oropharynx carcinoma. Computed tomography scan disclosed a left partitioned effusion of high abundance, responsible for a passive atelectasis of the left lower lobe and multiple bilateral pulmonary nodules. A drainage tube was inserted to allow the evacuation of serous liquid; biochemical examination revealed an exudative effusion with pseudochylothorax criteria. Because the daily chest drainage output remained greater than 1 L per day, videothoracoscopy p...Continue Reading

References

Dec 1, 1950·Diseases of the Chest·A GOLDMAN, T H BURFORD
Jan 31, 2012·Respiration; International Review of Thoracic Diseases·Francisco Rodriguez-Panadero, Ana Montes-Worboys
Sep 14, 2016·Journal of Thoracic Disease·Adriana LamaLuis Valdés

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Citations

Jul 3, 2020·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Cong ChenQiang Pu

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Methods Mentioned

BETA
biopsies

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