Yamada Tomoko, Sugano Koji, Matsuno Kei, Hotta Saori, Ayame Nana, Sugitani Honami, Mihara Makoto, Hara Hisako, Takahashi Kazuhisa, Seyama Kuniaki
Department of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Japan.
Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Japan.
Intern Med. 2025 Feb 1;64(3):397-403. doi: 10.2169/internalmedicine.3805-24. Epub 2024 Jun 13.
A 53-year-old man with chronic dyspnea and bilateral pleural effusion was subsequently diagnosed with idiopathic chylothorax. Lymphatic scintigraphy confirmed lymphatic fluid leakage at the left venous angle, prompting management with lymphaticovenular anastomosis (LVA). Although the left pleural effusion was controlled, the right pleural effusion continued to increase, resulting in bilateral leg lymphedema that was refractory to LVA. Approximately three years and three months after the presentation, the patient succumbed to CO narcosis and renal failure. It is crucial to study additional cases in order to uncover new causes and develop pathology-based treatments for this condition.
一名53岁男性,有慢性呼吸困难和双侧胸腔积液,随后被诊断为特发性乳糜胸。淋巴闪烁显像证实左静脉角处有淋巴液渗漏,促使采用淋巴管静脉吻合术(LVA)进行治疗。尽管左侧胸腔积液得到了控制,但右侧胸腔积液持续增加,导致双侧下肢淋巴水肿,LVA治疗无效。在出现症状约三年零三个月后,患者死于一氧化碳中毒和肾衰竭。研究更多病例以发现新病因并开发基于病理的治疗方法对于这种疾病至关重要。