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[Chylothorax in an 87-year-old patient]
M J Richter1, R Baumgartner, H H Leuchte
1Abteilung für Pneumologie, Medizinische Klinik II, Krankenhaus Neuwittelsbach, München, Deutschland.
Der Internist
|November 1, 2012
Summary
A rare case of post-menopausal pulmonary lymphangioleiomyomatosis caused chylothorax in an elderly woman. Diagnosing chylothorax involves checking triglyceride levels, and lymphangioleiomyomatosis should be considered in older patients with this condition.
Area of Science:
- Pulmonology
- Radiology
- Pathology
Background:
- Pleural effusion is a common clinical presentation requiring diagnostic work-up.
- Chylothorax, a rare form of pleural effusion, results from lymphatic fluid leakage.
- Pulmonary lymphangioleiomyomatosis (PLAM) is a rare neoplastic proliferation of smooth muscle cells.
Observation:
- An 87-year-old woman presented with a left-sided pleural effusion.
- The pleural fluid was milky and confirmed as chylothorax based on triglyceride levels.
- Thorax computed tomography (CT) revealed multiple pulmonary cysts.
Findings:
- The CT findings, in conjunction with the clinical presentation, led to the rare diagnosis of post-menopausal pulmonary lymphangioleiomyomatosis.
- This case highlights the importance of considering PLAM in the differential diagnosis of chylothorax, even in elderly patients.
- Triglyceride level determination is crucial for confirming chylothorax.
Implications:
- This case underscores the importance of a comprehensive diagnostic approach for pleural effusions.
- It expands the known age range for symptomatic PLAM presentation.
- Early recognition of chylothorax and its underlying causes like PLAM can guide appropriate management.
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