Haegeli A, Keller R
Schweiz Med Wochenschr. 1981 Jan 24;111(4):125-8.
Chylothorax with bilateral hilar and mediastinal lymphomas has been observed in a 27-year-old patient. Further clinical investigations revealed sarcoidosis with involvement of the mediastinal lymphnodes, the bronchial mucosa and the pleural mesothelium. It is suggested that the chylothorax is a complication of sarcoidosis, although pleural effusions of chylus have thus far been reported only in traumatic or malignant diseases of the mediastinum. The pathogenesis was unclear until exploration of the pleural space by thoracoscopy showed an intact and unaffected thoracic duct. During longterm treatment with corticosteroids, supported by several pleural drainages, the chylothorax and other concomitant symptoms gradually regressed.
一名27岁患者出现了伴有双侧肺门及纵隔淋巴瘤的乳糜胸。进一步的临床检查发现为结节病,累及纵隔淋巴结、支气管黏膜及胸膜间皮。尽管迄今为止乳糜性胸腔积液仅在纵隔创伤或恶性疾病中报道过,但提示该乳糜胸是结节病的一种并发症。在通过胸腔镜探查胸膜腔显示胸导管完整且未受影响之前,其发病机制尚不清楚。在长期使用皮质类固醇治疗并辅以多次胸腔引流的过程中,乳糜胸及其他伴随症状逐渐消退。