ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Neelakandan, B.
Right arrow Articles by Gupta, A. K.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Neelakandan, B.
Right arrow Articles by Gupta, A. K.

Ann Thorac Surg 1996;61:277
© 1996 The Society of Thoracic Surgeons

Correspondence

Delayed Chylothorax After Irradiation

B. Neelakandan, MCh, K. S. Neelakandhan, MCh, Arun K. Gupta, MD

Lister Hospital, 94, Kanagasabai nagar, Chidambaram 608 001, India
Departments of cardiothoracic vascular surgery, SCTIMST, Trivandrum 695 011, India

To the Editor:

There are many causes reported for chylothorax [1–3]. We would like to report a case of chylothorax after irradiation given 18 years ago for thyroid malignancy.

A 48-year-old man presented with dyspnea, right-sided chest pain, and low-grade fever of 1 week's duration. Examination revealed moderate cachexia and anemia and features of right-sided massive pleural effusion. Pleurocentesis revealed that the nature of the fluid was chyle. The biochemical examination confirmed it to be chyle. The microbial examination proved it to be free of bacteria. He denied a history of having undergone any chest operation or trauma. He gave a history of having undergone total thyroidectomy 18 years ago. The histopathology being papillary carcinoma, he had been given external irradiation then (probably due to the nonavailability of radioactive iodine). He had been asymptomatic since then. He had been taking thyroxin.

For the chylothorax he was managed by chest tube drainage, protein supplementation, and chest physiotherapy. The tube thoracostomy had to be kept for 3 weeks.

To find the cause of the chylothorax, we did computed tomographic scan of the chest and the neck and iodine scan. These were normal, proving absence of secondary thyroid malignancy. We did a lymphangiogram, which showed a block at the level of the posterior mediastinum at the D3 level. We presume that the cause of the chylothorax may be delayed mediastinal fibrosis due to radiotherapy. As for any other case of chylothorax, he was managed conservatively.

References

  1. Paes ML, Powell H. Chylothorax: an update. Br J Hosp Med 1994;51:482–90.[Medline]
  2. Delgado C, Martin M, de la Portilla F. Retrosternal goitre associated with chylothorax. Chest 1994;106:1924–5.[Abstract/Free Full Text]
  3. Johnstone DW, Feins RH. Chylothorax. Chest Surg Clin N Am 1994;4:617–28.[Medline]




This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Neelakandan, B.
Right arrow Articles by Gupta, A. K.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Neelakandan, B.
Right arrow Articles by Gupta, A. K.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS