Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer
Chylothorax presents as exudate with lymphocytic predominance and high triglyceride-low LDH levels, usually due to a traumatic disruption of the thoracic duct, possibly iatrogenic. Other causes include malignancy, sarcoidosis, goiter, AIDS, or tuberculosis. Here we present a case of a 66-year-old ma...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2019/9387021 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832547126764109824 |
|---|---|
| author | Nooraldin Merza John Lung Mazin Saadaldin Tarek Naguib |
| author_facet | Nooraldin Merza John Lung Mazin Saadaldin Tarek Naguib |
| author_sort | Nooraldin Merza |
| collection | DOAJ |
| description | Chylothorax presents as exudate with lymphocytic predominance and high triglyceride-low LDH levels, usually due to a traumatic disruption of the thoracic duct, possibly iatrogenic. Other causes include malignancy, sarcoidosis, goiter, AIDS, or tuberculosis. Here we present a case of a 66-year-old male who came in with cough and shortness of breath for few weeks. A week earlier, at an ED visit, he was diagnosed with pneumonia based on CT angiogram of the chest without contrast that showed bilateral pleural effusion and bilateral pulmonary infiltrates. The CT-guided placement of bilateral chest tube drained 1160 cc of creamy yellow fluid on the right and 1200 cc of creamy yellow fluid on the left. CT chest/abdomen/pelvis showed bilateral ground-glass opacities within the lungs and possible bony metastasis. A whole-body bone scan showed multiple bony metastatic lesions throughout the skeleton. IR guided bone biopsy suggested upper GI or pancreaticobiliary cancer. Venous ultrasound with Doppler of left upper extremity showed findings suggestive of a nonocclusive DVT of proximal/mid left subclavian vein which is difficult to compress. Eventually, malignancy-related DVT of the left subclavian/brachiocephalic vein was identified as the possible etiology for the bilateral chylothorax. |
| format | Article |
| id | doaj-art-0a0889e2100c4c53ae6fb1890cc8ceb3 |
| institution | Kabale University |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-0a0889e2100c4c53ae6fb1890cc8ceb32025-02-03T06:45:57ZengWileyCase Reports in Pulmonology2090-68462090-68542019-01-01201910.1155/2019/93870219387021Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal CancerNooraldin Merza0John Lung1Mazin Saadaldin2Tarek Naguib3Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, TX, USASchool of Medicine, Texas Tech University Health Sciences Center, Amarillo, TX, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, TX, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, TX, USAChylothorax presents as exudate with lymphocytic predominance and high triglyceride-low LDH levels, usually due to a traumatic disruption of the thoracic duct, possibly iatrogenic. Other causes include malignancy, sarcoidosis, goiter, AIDS, or tuberculosis. Here we present a case of a 66-year-old male who came in with cough and shortness of breath for few weeks. A week earlier, at an ED visit, he was diagnosed with pneumonia based on CT angiogram of the chest without contrast that showed bilateral pleural effusion and bilateral pulmonary infiltrates. The CT-guided placement of bilateral chest tube drained 1160 cc of creamy yellow fluid on the right and 1200 cc of creamy yellow fluid on the left. CT chest/abdomen/pelvis showed bilateral ground-glass opacities within the lungs and possible bony metastasis. A whole-body bone scan showed multiple bony metastatic lesions throughout the skeleton. IR guided bone biopsy suggested upper GI or pancreaticobiliary cancer. Venous ultrasound with Doppler of left upper extremity showed findings suggestive of a nonocclusive DVT of proximal/mid left subclavian vein which is difficult to compress. Eventually, malignancy-related DVT of the left subclavian/brachiocephalic vein was identified as the possible etiology for the bilateral chylothorax.http://dx.doi.org/10.1155/2019/9387021 |
| spellingShingle | Nooraldin Merza John Lung Mazin Saadaldin Tarek Naguib Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer Case Reports in Pulmonology |
| title | Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer |
| title_full | Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer |
| title_fullStr | Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer |
| title_full_unstemmed | Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer |
| title_short | Bilateral Chylothorax as a Unique Presentation of Pancreaticobiliary or Upper Gastrointestinal Cancer |
| title_sort | bilateral chylothorax as a unique presentation of pancreaticobiliary or upper gastrointestinal cancer |
| url | http://dx.doi.org/10.1155/2019/9387021 |
| work_keys_str_mv | AT nooraldinmerza bilateralchylothoraxasauniquepresentationofpancreaticobiliaryoruppergastrointestinalcancer AT johnlung bilateralchylothoraxasauniquepresentationofpancreaticobiliaryoruppergastrointestinalcancer AT mazinsaadaldin bilateralchylothoraxasauniquepresentationofpancreaticobiliaryoruppergastrointestinalcancer AT tareknaguib bilateralchylothoraxasauniquepresentationofpancreaticobiliaryoruppergastrointestinalcancer |