Female with Shortness of Breath

Chylothorax is characterized by pleural fluid with a turbid or milky appearance due to high triglyceride content in the form of chylomicrons that enters the pleural space as a chyle most commonly from the disruption of the thoracic duct. The chyle is rich in triglycerides, which produces the milky, opalescent appearance of the pleural fluid. Chyle also contains lymphocytes as the major cellular content. The electrolyte content ofthe chyle is similar to plasma and the protein content is usually greater than 3 g/dl. The diagnosis of chylothorax is made by the milky appearance of the pleural fluid and by measuring the pleural fluid triglyceride concentration which is typically more than 110 mg/dl or in cases in which the triglycerides are between 50-110 mg/dl by lipoprotein analysis of the pleural fluid which shows the presence of chylomicrons.

Malignancy is a leading cause of non-traumatic chylothorax responsible for 63% of non-traumatic causes. Lymphoma is the single most common cause responsible for 50% of the non-traumatic causes. Other common causes of chylothorax are Castleman's disease, sarcoidosis, histoplasmosis, lymphangioleiomyomatosis, Noonan syndrome, filariasis, heart failure, lymphangitis of the thoracic duct, aneurysm of the thoracic aorta that erodes the duct, Cirrhosis of the liver, childbirth and idiopathic.Surgical procedures and chest trauma are the most common causes of the traumatic chylothorax .Read more.......