Tuberc Respir Dis.  2009 Nov;67(5):458-461.

A Case of Pseudochylothorax Developed from Chronic Pleural Effusion after Treatment of Tuberculous Pleurisy

• Park EK
• Chung SH
• Bae JH
• Ryu SR
• Lee JH
• Kim SH
• Cho YU
• Chae JD
• Lee BH

Abstract

A pseudochylothorax, a chyliform pleural effusion, is a rare disease of pleural effusion that contains cholesterol crystals or high lipid content that is not the result of a disrupted thoracic duct. Most of the cases were found in patients with long-standing pleural effusion due to chronic inflammatory disease, such as old tuberculous pleurisy or chronic rheumatoid pleurisy. We experienced a case of pseudochylothorax in a 74-year-old man, who was being treated for pulmonary tuberculosis and pleurisy 10 years ago. The diagnosis was confirmed on pathological study of the pleural effusion, which contained cholesterol crystals having a diagnostic rhomboid appearance.

Keyword

Pseudochylothorax; Cholesterol; Pleural Effusion

MeSH Terms

Aged
Cholesterol
Humans
Pleural Effusion
Pleurisy
Rare Diseases
Thoracic Duct
Tuberculosis, Pleural
Tuberculosis, Pulmonary
Cholesterol

Figure

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  Figure 1 Simple chest X-ray demonstrates right loculated pleural effusion and bilateral pleural thickening.

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  Figure 2 Chest CT scan reveals fibrotic change and multiple calcified nodules with grossly thickening of the right pleural membranes enclosing a massive effusion.

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  Figure 3 Microscopic examination of pleural effusion. Window-pane with a corner missing appearance of cholesterol crystals is seen in pleural effusion (×400).

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