Isolated idiopathic chylopericardium.

The case history of a young asymptomatic patient with primary chylous pericardium is reported. On the basis of this case and those reported in the literature, we suggest that diagnosis should be established by echocardiograms, cardiac angiograms, and pericardiocentesis. Lymphangiograms are useful for the detection of the underlying abnormality of the lymph vessels. Pericardiectomy together with thoracic duct ligation are suggested as the preferred treatment. We propose that generalized lymphatic abnormality is the underlying mechanism of this entity. This lymphatic abnormality could be associated with impaired cellular immunity, although no such impairment was found in our patient.