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Chylothorax — SCE Respiratory MCQ

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ModeratePleural DiseaseChylothoraxSCE Respiratory

A 60-year-old woman develops a large left pleural effusion 3 months after lymphoma diagnosis. Pleural fluid is milky; triglyceride concentration is 2.4 mmol/L and cholesterol is 1.1 mmol/L. Cytology shows lymphocytes. What is the most likely diagnosis?

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Correct answer: B — Chylothorax

A milky effusion with pleural triglycerides above 1.24 mmol/L is diagnostic of chylothorax, and lymphoma is a common non-traumatic cause. Pseudochylothorax has high cholesterol and usually chronic inflammatory pleural disease. Empyema, mesothelioma and rheumatoid pleuritis have different biochemical and clinical profiles.

Reference: BTS Pleural Disease Guideline 2023