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[Pseudochylothorax. Review of 5 cases]

F Campos Rodríguez1, I Alfageme Michavila, J Hernández Borge

  • 1Sección de Neumología, Hospital Universitario de Valme, Sevilla.

Archivos De Bronconeumologia
|February 12, 1998
PubMed
Summary

Pseudo-chylothorax, a rare condition characterized by cholesterol crystals in pleural fluid, is often linked to prior tuberculosis. Diagnosis requires careful evaluation, considering potential tuberculosis reactivation or infected pleural effusion.

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Area of Science:

  • Pulmonology
  • Thoracic Medicine
  • Medical Diagnostics

Background:

  • Pseudo-chylothorax is a rare pleural effusion.
  • It is characterized by cholesterol crystals (CC) or elevated cholesterol levels (>150 mg/dl) in the absence of chylomicrons.
  • This condition is often associated with underlying chronic conditions.

Purpose of the Study:

  • To review cases of pseudo-chylothorax diagnosed at a single institution.
  • To identify clinical characteristics, diagnostic methods, and treatment outcomes.
  • To highlight the association with prior tuberculosis and diagnostic challenges.

Main Methods:

  • Retrospective review of five patients diagnosed with pseudo-chylothorax between 1984 and 1994.
  • Diagnostic criteria included presence of cholesterol crystals or cholesterol concentration >150 mg/dl with absent chylomicrons.

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  • Patient history, diagnostic findings, and treatment interventions were analyzed.

    • Main Results:

    • Five male patients with a mean age of 53 years were identified.
    • All patients had a history of pulmonary or pleural tuberculosis (mean 31 years post-diagnosis).
    • Four diagnoses were based on cholesterol crystals; two cases involved Mycobacterium tuberculosis isolation and one required decortication.

    Conclusions:

    • Pseudo-chylothorax is currently rare and frequently associated with antecedent tuberculosis and residual pleural disease.
    • Diagnosis often occurs during investigations for other conditions.
    • Consideration of infected pleural effusion or tuberculosis reactivation is crucial in diagnosis.