Abstract

The aim of this study was to evaluate the clinical, radiologic and pleural effusion findings of patients who were diagnosed as pseudochylothorax in our clinic between 1 July 1998 and 31 December 2003. The files and records of the patients who were diagnosed as pseudochylothorax in our clinic were retrospectively reviewed to identify patients and all the data including demographic characteristics, history, physical examination findings, pleural fluid features, radiographic features and spirometric studies. The study group included 5 male and 1 female patients aged 62 to 82 years with a mean age of 72 years. Two patients were symptomatic. Their past history were significant for tuberculosis. All the patients had been given antituberculous drugs. In additon to the medical therapy one patient with pulmonary tuberculosis had undergone collaps therapy and the other had undergone pulmonary resection. All of the pleural fluid were turbid and the turbidity persisted after centrifugation. Mean pleural fluid cholesterol level was 317.8 mg/dL (244-421 mg/dL) and cholesterol crystals were seen on microscopical examination of all pleural fluids. Spiral computed tomography revealed thickening and calcification of both parietal and visceral membranes and also some calcified foci in pleural fluids of four patients. There was no growth on tuberculosis culture of the pleural fluids. One patient who was diagnosed as peritoneal tuberculosis was given antituberculosis therapy, the patient with effort dyspnea undergone therapeutic thoracentesis. The other four patients were followed without treatment. In conclusion when thoracentesis yields a milky or turbid fluid, differential diagnosis should include pseudochylothorax as well and pleural fluid cholesterol levels must be measured. Especially, a past history of tuberculosis (pleural or pulmonary) and thickening and calcification of both parietal and visceral pleural membranes on thoracic CT scans strenghthen the diagnosis of pseudochylothorax.