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Chylothorax bei einer 87-jährigen Patientin

Chylothorax in an 87-year-old patient

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Zusammenfassung

Eine 87-jährige Patientin wurde mit einem linksseitigen Pleuraerguss aufgenommen. Das milchige Punktat erfüllte die Kriterien eines Chylothorax. Die Computertomographie des Thorax zeigte multiple Zysten, daher wurde die äußerst seltene Diagnose einer postmenopausalen Lymphangioleiomyomatose gestellt. Die Analyse eines Pleurapunktats sollte neben der makroskopischen Beurteilung die Bestimmung der Triglyzeride umfassen, um die Diagnose eines Chylothorax bestätigen zu können. Selbst im fortgeschrittenen Alter sollte bei Vorliegen eines Chylothorax die Differenzialdiagnose einer Lymphangioleiomyomatose in Betracht gezogen werden.

Abstract

An 87-year-old woman presented with a left-sided pleural effusion. The milky aspirate fulfilled the criteria of a chylothorax. Thorax computed tomography (CT) showed characteristic multiple cysts and consequently the rare diagnosis of post-menopausal pulmonary lymphangioleiomyomatosis was made. In the diagnostic work-up of pleural effusion the determination of triglycerides should be considered to confirm the diagnosis of chylothorax. In the presence of a chylothorax the differential diagnosis of lymphangioleiomyomatosis should be included even in advanced age.

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Literatur

  1. Baldi S, Papotti M, Valente ML et al (1994) Pulmonary lymphangioleiomyomatosis in postmenopausal women: report of two cases and review of the literature. Eur Respir J 7:1013–1016

    Google Scholar 

  2. Dabora SL, Franz DN, Ashwal S et al (2011) Multicenter phase 2 trial of sirolimus for tuberous sclerosis: kidney angiomyolipomas and other tumors regress and VEGF-D levels decrease. PLoS One 6:e23379

    Article  PubMed  CAS  Google Scholar 

  3. Ho TB, Hull JH, Hughes NC (2006) An 86-year-old female with lymphangioleiomyomatosis. Eur Respir J 28:1065

    Article  Google Scholar 

  4. Johnson SR (2006) Lymphangioleiomyomatosis. Eur Respir J 27:1056–1065

    Google Scholar 

  5. Johnson SR, Cordier JF, Lazor R et al (2010) European Respiratory Society guidelines for the diagnosis and management of lymphangioleiomyomatosis. Eur Respir J 35:14–26

    Article  Google Scholar 

  6. Johnson SR, Whale CI, Hubbard RB et al (2004) Survival and disease progression in UK patients with lymphangioleiomyomatosis. Thorax 59:800–803

    Article  PubMed  CAS  Google Scholar 

  7. Maldonado F, Hawkins FJ, Daniels CE et al (2009) Pleural fluid characteristics of chylothorax. Mayo Clin Proc 84:129–133

    Article  PubMed  Google Scholar 

  8. McCormack FX, Inoue Y, Moss J et al (2011) Efficacy and safety of sirolimus in lymphangioleiomyomatosis. N Engl J Med 364:1595–1606

    Google Scholar 

  9. Neurohr C, Hoffmann AL, Huppmann P et al (2011) Is sirolimus a therapeutic option for patients with progressive pulmonary lymphangioleiomyomatosis? Respir Res 12:66

    Article  PubMed  CAS  Google Scholar 

  10. Reid JK, Rees H, Cockcroft D (2002) Long term survival in a patient with pulmonary lymphangioleiomyomatosis. Can Respir J 9:342–346

    Google Scholar 

  11. Ryu JH, Doerr CH, Fisher SD et al (2003) Chylothorax in lymphangioleiomyomatosis. Chest 123:623–627

    Article  PubMed  Google Scholar 

  12. Watz H, Oltmanns A, Kimmel S et al (2008) Sporadic lymphangioleiomyomatosis. Clinical and lung functional characteristics of 32 female patients. Dtsch Med Wochenschr 133:705–708

    Article  PubMed  CAS  Google Scholar 

  13. Doerr CH, Allen MS, Nichols FC 3rd, Ryu JH (2005) Etiology of chylothorax in 203 patients. Mayo Clin Proc 80:867–870

    Article  PubMed  Google Scholar 

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Correspondence to H.H. Leuchte.

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Richter, M., Baumgartner, R. & Leuchte, H. Chylothorax bei einer 87-jährigen Patientin. Internist 54, 105–109 (2013). https://doi.org/10.1007/s00108-012-3158-7

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  • DOI: https://doi.org/10.1007/s00108-012-3158-7

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