Uncommon aetiologies of chylothorax: superior vena cava syndrome and thoracic aortic aneurysm

Abstract

Background: Chylothorax, an uncommon cause of pleural effusion, results from the accumulation of lymph in the pleural space due to damage or obstruction of the thoracic duct. The high content of triglycerides and the presence of chylomicrons in the pleural fluid sets the diagnosis.

Objective: To present a case report of a chylothorax due to superior vena cava compression or a thoracic aortic aneurysm, discuss the particularities, the investigation of chylothorax as well as its treatment options.

Methods: A review of the literature on chylothorax was performed using PubMed to assess the different aetiologies, investigation and treatments usually performed.

Conclusion: Chylothorax is usually secondary to malignancy, trauma, congenital diseases and infections. However, less common causes are also described, as the ones described in our case report. The gold standard for diagnosis is the identification of chylomicrons in the pleural fluid. Conservative management is recommended in most cases of chylothorax.

Keywords: chylothorax; superior vena cava syndrome; thoracic aortic aneurysm.