Campos Rodríguez F, Alfageme Michavila I, Hernández Borge J, Villagómez Cerrato R, Vargas Puerto A
Sección de Neumología, Hospital Universitario de Valme, Sevilla.
Arch Bronconeumol. 1997 Sep;33(8):422-5.
We undertook a retrospective review of five patients with pseudo-chylothorax diagnosed at our hospital between 1984 and 1994. Pseudo-chylothorax was diagnosed if crystals of cholesterol were observed (CC) or if cholesterol concentrations were over 150 mg/dl, but chylomicrons were absent from pleural effusions with cloudy supernatants after centrifugation. The five patients were males and their mean age was 53 years. All had history of pulmonary or pleural tuberculosis (mean 31 years since diagnosis). All had received chemotherapy and four had undergone therapeutic pneumothorax. Two patients were diagnosed in the course of examination for other reasons, Three were diagnosed while being examined for the cause of pleural effusion. The diagnosis of four patients was based on the presence of CC. Three patients received specific treatment and Mycobacterium tuberculosis was isolated in the pleural fluid of two. One patient required a pleural drain and antibiotics because of empyema related to pseudo-chylothorax. Decortication was needed by two. 1) Pseudo-chylothorax is at present rare. 2) All the cases we saw were associated with earlier tuberculosis infection with residual pleural lesions. 3) Diagnosis usually occurs in the course of examination for the other motives, but the possibility of infected pleural effusion or reactivation of tuberculosis should be considered.
我们对1984年至1994年间在我院诊断为假性乳糜胸的5例患者进行了回顾性研究。如果观察到胆固醇结晶（CC）或胆固醇浓度超过150mg/dl，但离心后上清液浑浊的胸腔积液中不存在乳糜微粒，则诊断为假性乳糜胸。这5例患者均为男性，平均年龄53岁。所有患者都有肺或胸膜结核病史（自诊断以来平均31年）。所有患者均接受过化疗，4例接受过治疗性气胸。2例患者在因其他原因检查过程中被诊断，3例在检查胸腔积液病因时被诊断。4例患者的诊断基于CC的存在。3例患者接受了特异性治疗，2例患者的胸腔积液中分离出结核分枝杆菌。1例患者因与假性乳糜胸相关的脓胸需要胸腔引流和使用抗生素。2例患者需要进行胸膜剥脱术。1）假性乳糜胸目前较为罕见。2）我们所见的所有病例均与早期结核感染及残留胸膜病变有关。3）诊断通常在因其他原因检查过程中做出，但应考虑感染性胸腔积液或结核复发的可能性。
