Chyloptysis with chylopericardium, a rare case and mini-review

Xuming Luo,Xiandong Gu,Xiongbiao Wang,Zhuhua Zhang,Shiqiang Wang

doi:10.1186/s12890-018-0583-y

Xuming Luo, Xiandong Gu + Show 3 more

Open Access

https://doi.org/10.1186/s12890-018-0583-y

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Abstract

BackgroundChyloptysis is reflux of chyle into the lungs and is a rare manifestation of primary chylous disorders.Case presentationOver 29 months, on the basis of x-rays, a 33-year-old female was repeatedly misdiagnosed with recurrent right-sided pneumonia; her symptoms included a recurrent cough, the appearance of cheese-like sputum, and diffuse pulmonary exudates. There was a history that abundant fluid in the pericardium was confirmed with echocardiography to have been present and asymptomatic for 4 years. Lymphangiography and surgery confirmed that the terminal portion of the thoracic duct was compressed by thick fibrous tissue and the vascular sheath of the internal jugular vein. Chyloptysis caused by high peribronchial lymphatic pressure was diagnosed and surgical intervention relieved the symptoms.ConclusionChyloptysis is rare and easy to misdiagnose but is a typical symptom of chylous reflux syndrome.

Highlights

Chyloptysis is reflux of chyle into the lungs and is a rare manifestation of primary chylous disorders
Chyloptysis is the expectoration of chyle [9]; its rarity caused the patient depicted here to be misdiagnosed with recurrent pneumonia for 29 months, since the chyloptysis was not recognized and the pericardial effusion not aspirated
To our knowledge, this is the first case in the literature regarding primary chyloptysis caused by mechanical compression and pulling of the thoracic duct with recurrent episodes of chyloptysis associated with chylopericardium

Summary

Introduction

Chyloptysis is reflux of chyle into the lungs and is a rare manifestation of primary chylous disorders. The end of the thoracic duct, ampulla, and various lymphatic trunks were found to be parceled and compressed by thicker fibrous tissue and a vascular sheath of the internal jugular vein. Chylous reflux was observed in the lymphatic tubes of the neck, bronchomediastinal, and subclavian trunks.

Results

Conclusion