Primary chylopericardium: the role of lymphangiography

Primary chylopericardium is often a benign asymoptomatic disease, but patients with associated mediastinal lymphatic tumors may develop cardiac tamponade. Lymphangiography demonstrates mediastinal lymphatic abnormalities in these high risk patients on whom subtotal pericardiectomy and thoracic duct ligation should be performed. Since such tumors have been found in half of reported cases and because extrathoracic lymphangiomas may coexist, lymphangiography with skeletal survey is recommended in all cases. These conclusions are based on a review of 31 published cases and an additional case of our own. Lymphangiographic findings were available in 17 of these patients.