Pleural fluid milkshakes: three cases with different aetiologies

Contrary to popular belief, the classical milky appearance of pleural fluid is seen in less than half of patients with chylothorax. In this case series, we present three patients with biochemically proven chylothorax: each with a different presentation, pleural fluid appearance, underlying cause, management strategy, and clinical outcome. Lymphoma, tuberculosis, and presumed amyloidosis are underlying causes in our patients. AbstractIn clinical practice, chylothorax is usually suspected in any patient with milky pleural fluid. However, contrary to popular belief, milky appearance of pleural fluid is seen in less than half of patients with chylothorax. A high index of suspicion for chylothorax is therefore needed in any turbid, bloody, or serosanguinous effusions of unclear aetiology. In this case series, we present three patients with biochemically proven chylothorax: each with a different presentation, pleural fluid appearance, underlying cause, management strategy and clinical outcome. The first patient developed ‘milky’ chylothorax secondary to lymphoma while the second patient's ‘yellow’ chylothorax is related to pleural tuberculosis. The final patient suffered from ‘pink’ chylothorax in the setting of systemic amyloidosis. In each of the cases, prompt diagnosis of chylothorax followed by effor ts to elucidate the underlying cause are crucial steps to guide subsequent management with the main aim to ensure a better clinical outcome.

Source: Respirology Case Reports - March 8, 2023 Category: Respiratory Medicine Authors: Nai ‐Chien Huan, Hooi Ann Tan, Hema Yamini Ramarmuty, Subramaniam Ponnuvelu, Shivaanand Letcheminan, Kunji Kannan Sivaraman Kannan Tags: CASE SERIES Source Type: research