Spontaneous chylopericardium: delineation of the underlying anatomic pathology by CT lymphangiography

Primary isolated chylopericardium is a rare condition with little known cause. This is the case of a 22-year-old woman in whom idiopathic chylopericardium developed. A lymphangiogram followed by a computed tomographic scan demonstrated occlusion of the thoracic duct and multiple lymphatic collaterals abutting the pericardial sac. Thoracic duct ligation resulted in the complete cure of the patient's condition. We theorized that the development of the pathologic lymphatic ducts in close proximity to the pericardium resulted in the development of the slowly accumulating chylopericardium.