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Park, Chung, Bae, Ryu, Lee, Kim, Cho, Chae, and Lee: A Case of Pseudochylothorax Developed from Chronic Pleural Effusion after Treatment of Tuberculous Pleurisy
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(5): 458-461.

Published online: 30 November 2009

DOI: https://doi.org/10.4046/trd.2009.67.5.458

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

Eun Kyoung Park, M.D.1, Sook Hee Chung, M.D.1, June Ho Bae, M.D.1, Sang Ryol Ryu, M.D.1, Jae Hyung Lee, M.D.1, Sang Hoon Kim, M.D.1, Young Uk Cho, M.D.2, Jeong Don Chae, M.D.2, Byoung Hoon Lee, M.D.1

1Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.

2Department of Clinical Pathology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.

Address for correspondence: Byoung Hoon Lee, M.D. Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, 280-1, Hagye 1-dong, Nowon-gu, Seoul 139-711, Korea. Phone: 82-2-970-8625, Fax: 82-2-970-8621, hoonakr@eulji.ac.kr

Received 25 August 2009       Accepted 21 September 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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.

Keywords: Pseudochylothorax, Cholesterol, Pleural Effusion

Figures and Tables

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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