Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

Chylothorax

Reference work entry
DOI: https://doi.org/10.1007/978-3-319-66796-6_350

Synonyms

Chylous effusion; Chylous hydrothorax; Chylopleura

Definition

Chylothorax is an accumulation of lymphatic fluid within the pleural space. The effusion has an elevated concentration of neutral emulsified fats with triglyceride levels over 110 mg/dL, a cell count typically greater than 1,000 cells/μL, which is comprised of usually greater than 80% lymphocytes. The accumulation is the result of a variety of pathophysiologic mechanisms that ultimately impair the function of the thoracic duct, through direct damage or obstruction. Chylothorax is therefore a common final pathway of a heterogeneous group of diseases. Radiographic findings are nonspecific with regard to other effusions, but are characterized by blunting of the costophrenic angle on upright radiography.

The most common causes of chylothorax include trauma to the thoracic duct and lymphoreticular malignancy, which, for the latter, may be the presenting sign. Chylothorax is also caused by solid malignancies, superior...

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References and Further Reading

  1. Büttiker, V., Fanconi, S., & Burger, R. (1999). Chylothorax in children: Guidelines for diagnosis and management. Chest, 116(3), 682–687.CrossRefGoogle Scholar
  2. Platis, I. E., & Nwogu, C. E. (2006). Chylothorax. Thoracic Surgery Clinics, 16(3), 209–214.CrossRefGoogle Scholar
  3. Sieczk, E. M., & Harvey, J. C. (1996). Early thoracic duct ligation for postoperative chylothorax. Journal of Surgical Oncology, 61, 56–60.CrossRefGoogle Scholar
  4. Spieler, P. (1979). The cytologic diagnosis of tuberculosis in pleural effusions. Acta Cytologica, 23(5), 374–379.PubMedGoogle Scholar
  5. Teng, C. L., Li, K. W., Yu, J. T., Hsu, S. L., Wang, R. C., & Hwang, W. L. (2012). Malignancy-associated chylothorax: A 20-year study of 18 patients from a single institution. European Journal of Cancer Care (England), 21(5), 599–605.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyUniversity of Texas Medical BranchGalvestonUSA