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Vol. 15. Issue 3.
Pages 521-527 (May - June 2009)
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Vol. 15. Issue 3.
Pages 521-527 (May - June 2009)
Caso Clínico/Case Report
Open Access
Quilotórax: A propósito de um caso clínico
Chylothorax – Case report
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Ricardo José Brito Pereira de Lima1,
Corresponding author
ricardo9lima@hotmail.com

Serviço de Pneumologia do Centro Hospitalar de Vila Nova de Gaia / Espinho, Directora de Serviço – Dra. Bárbara Parente, R. Conceição Fernandes, Vila Nova de Gaia 4430-000 Vila Nova de Gaia.
, Carla Cristina de Sousa Nogueira1, Javier Porteiro Sanchez2, Maria Teresa Shiang Tzer3, Maria Manuela Queirós Rola3
1 Interno Complementar de Pneumologia, Centro Hospitalar de Vila nova de Gaia / Espinho EPE
2 Interno Complementar de Medicina Interna, Centro Hospitalar de Vila nova de Gaia / Espinho EPE
3 Assitente Graduada de Pneumologia, Centro Hospitalar de Vila nova de Gaia / Espinho EPE
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Resumo

O quilotórax caracteriza-se pela presença de linfa no espaço pleural devido a lesão ou obstrução do ducto torácico. O diagnóstico é feito com base no elevado conteúdo de triglicéridos e na presença de quilomí-crons. A etiologia do quilotórax pode ser dividida em traumática e não traumática. A ruptura traumática ocorre após acidentes ou cirurgias. Das causas não traumáticas, a mais comum é o linfoma e, na presença de um quilotórax de etiologia desconhecida, a primei-ra suspeita diagnóstica deverá ser dirigida para esta entidade, sendo o tipo mais frequente o não Hodgkin. Os autores apresentam o caso de um doente com quilotórax, cujo diagnóstico etiológico foi de linfoma não Hodgkin, discutem os aspectos particulares do quilotórax, bem como a investigação e modalidades de tratamento desta entidade.

Rev Port Pneumol 2009; XV (3): 521-527

Palavras-chave:
Quilotórax
empiema
pleurodese
toracoscopia
linfoma
Abstract

Chylothorax is the occurrence of lymph in the pleu-ra due to damage or obstruction of the thoracic duct. High content of triglycerides and the presence of chylomicrons make the diagnosis of chylothorax. Its aetiology can be divided in traumatic and non-traumatic. Traumatic rupture occurs after accidents or surgery. Within non-traumatic aetiology, lymphoma is the most common and in the presence of a chylothorax of unknown origin this should be the first suspicion, being non-Hodgkin type the most frequent.

The authors present a case report of a patient with chylothorax due to non-Hodgkin lymphoma, discuss the particularities of chylothorax as well as the investigation and its treatment options.

Rev Port Pneumol 2009; XV (3): 521-527

Key-words:
Chylothorax
empyema
pleurodesis
thoracoscopy
lymphoma
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Bibliografia
[1.]
G. Hillerdal.
Chylothorax and pseudochylothorax.
Eur Respir J, 10 (1997), pp. 1157-1162
[2.]
B.A. Staats, R.D. Ellefson, L.L. Budahn, D.E. Dines, U.B.S. Prakash, K. Offord.
The lipoprotein profile of chylous and nonchylous pleural effusions.
Mayo Clin Proc, 55 (1980), pp. 700-704
[3.]
R. Loddenkemper, W. Frank.
Pleural Disease.
Respiratory medicine, 3, pp. 1907-1937
[4.]
A. Garcia-Zamalloa, G. Ruiz-Irastorza, F.J. Aguayo, N. Gurrutxaga.
Pseudochylothorax. Report of 2 cases and review of the literature.
Medicine (Baltimore), 78 (1999), pp. 200
[5.]
R.W. Light.
Chylothorax and pseudochylothorax.
5, pp. 346-361
[6.]
C.H. Doerr, M.S. Allen, F.C. Nichols III, J.H. Ryu.
Etiology of chylothorax in 203 patients.
Mayo Clin Proc, 80 (2005), pp. 867-870
[7.]
G. Hillerdal.
Effusions from lymphatic disruptions.
Textbook of pleural diseases. London, pp. 362-367
[8.]
K. Shimizu, J. Yoshida, M. Nishimura.
Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer.
J Thorac Cardiovasc Surg, 124 (2002), pp. 499-502
[9.]
M.G. Alexandrakis, F.H. Passam, D.S. Kyriakou, D. Bouros.
Pleural effusions in hematologic malignancies.
Chest, 125 (2004), pp. 1546-1555
[10.]
U.B.S. Prakash.
Chylothorax and pseudochylothorax.
Eur Respir Mon, 7 (2002), pp. 249
[11.]
A. O′Callaghan, G. Mead.
Chylothorax in lymphoma: mechanism and management.
Ann Oncol, 6 (1995), pp. 603-607
[12.]
I. Kalomenidis.
Octreotide and chylothorax.
Cur Opin Pul Dis, 12 (2006), pp. 264-267
[13.]
A.G.C. Andrés, C.M. Fernández, F.J.M. Díez, V.D.H. Gude, J.A.P. Antón, J.L.M. Nicolás.
Tratamiento conservador con octreótido del quilotórax posquirúrgico.
Arch Bronconeumol, 40 (2004), pp. 473-475
[14.]
D. Weissberg, I. Ben-Zeev.
Pleurodesis talc. Experience 360 patients.
J Thorac Cardiovasc Surg, 106 (1993), pp. 689-695
[15.]
F.S. Vargas, J.R.C. Milanez, L.T.B. Filomeno, L. Tarcisio.
Intrapleural talc for the prevention of recurrence in bening or undiagnosed pleural effusions.
Chest, 106 (1994), pp. 1771-1775
[16.]
D.D. Graham, E.D. McGahren, C.G. Tribble.
Use of video-assisted thoracic surgery in the treatment of chylothorax.
Ann Thorac Surg, 57 (1994), pp. 1507-1511
[17.]
D.C. Mares, P.N. Marthur.
Medical thoracoscopic talc pleurodesis for chylothorax due to lymphoma: a case series.
Chest, 114 (1998), pp. 731-735
[18.]
R.W. Light.
Is talc indicated for Pleurodesis?.
Journal of Bronchology, 9 (2002), pp. 228-231
[19.]
S. Gyorik, S. Erni, U. Studler, R. Hodek-Wuerz, M. Tamm, P. Chhajed.
Long-term follow-up of thoracoscopic talc pleurodesis for primary spontaneous pneumothorax.
Eur Respir J, 29 (2007), pp. 757-760
[20.]
S.A. Sahn.
Is talc Indicated for Pleurodesis?.
Journal of Bronchology, 9 (2002), pp. 223-227
[21.]
F. Rodriguez-Panadero, V.B. Antony.
Pleurodesis: state of the art.
Eur Respir J, 10 (1997), pp. 1648-1654
[22.]
J.E. Heffner.
Diagnosis and management of chylothorax and cholesterol effusion, (2008),
[23.]
M.A.C. Vaz, P.P. Fernandes.
Quilotórax.
J Bras Pneumol, 34 (2006), pp. s197-s203
[24.]
A.G. Little, M.H. Kadowaki, M.K. Fergunson, et al.
Pleuroperitoneal shunting: alternative therapy for pleural effusion.
Ann Surg, 48 (1988), pp. 195-200
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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