Chyle: a masquerading etiology of pericardial effusion

A 25-year-old man with massive pericardial effusion is presented. The high lymphocyte amount and cytological analysis of the aspirated fluid suggested tuberculous or malignant pericarditis. The chylous nature of the effusion was only recognized after hemipericardiectomy, when reaccumulation of fluid into the pleural space appeared. This was successfully managed by medium chain triglyceride diet.