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Case Reports

Spontaneous Chylopericardium: Delineation of the Underlying Anatomic Pathology by CT Lymphangiography

^a Hospital of University of Pennsylvania, Philadelphia, Pennsylvania
^b Abington Medical Specialists, Abington, Pennsylvania
^c Stanford University School of Medicine, Stanford, California

Accepted for publication September 19, 2008.

^_* Address correspondence to Dr Itkin, University of Pennsylvania, 109 Penarth Rd, Bala Cynwyd, PA 19004 (Email: itkinmax{at}uphs.upenn.edu).

Primary isolated chylopericardium is a rare condition with little known cause. This is the case of a 22-year-old woman in whom idiopathic chylopericardium developed. A lymphangiogram followed by a computed tomographic scan demonstrated occlusion of the thoracic duct and multiple lymphatic collaterals abutting the pericardial sac. Thoracic duct ligation resulted in the complete cure of the patient's condition. We theorized that the development of the pathologic lymphatic ducts in close proximity to the pericardium resulted in the development of the slowly accumulating chylopericardium.