Randy R. Richardson, MD; A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Synonyms
Chylous fluid in pleural space
Definitions
Lymphatic fluid in pleural space secondary to congenital or acquired conditions, including obstruction, congenital anomaly, increased pressure, impaired drainage, or trauma to thoracic duct
Thoracic duct is major central lymphatic vessel
Extends in paraspinal tissues from cisterna chyli to point of drainage into left subclavian/brachiocephalic vein
Drains lymph from lower limbs, pelvis, abdomen
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
CT Findings
Lymphangiogram
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Brock WW et al: Congenital chylothorax: a unique presentation of nonimmune hydrops fetalis in a preterm infant. Adv Neonatal Care. 16(2):114-23, 2016
Bang JH et al: Anatomic variability of the thoracic duct in pediatric patients with complex congenital heart disease. J Thorac Cardiovasc Surg. 150(3):490-5, 2015
Bialkowski A et al: Congenital chylothorax: a prospective nationwide epidemiological study in Germany. Arch Dis Child Fetal Neonatal Ed. 100(2):F169-72, 2015
Krishnamurthy R et al: Imaging the central conducting lymphatics: initial experience with dynamic MR lymphangiography. Radiology. 274(3):871-8, 2015
Bengtsson BO: Outcome of neonatal chylous effusions: what do you tell the parents? A 10-year experience in a community hospital. Am J Perinatol. 31(12):1037-42, 2014
Downie L et al: Congenital chylothorax: associations and neonatal outcomes. J Paediatr Child Health. 50(3):234-8, 2014
Gray M et al: Treatment of congenital pulmonary lymphangiectasia using ethiodized oil lymphangiography. J Perinatol. 34(9):720-2, 2014
Lomauri Kh: Congenital chylothorax in newborn with trisomy 21. Georgian Med News. 74-7, 2014
Lopez-Gutierrez JC et al: Chylothorax and chylous ascites: management and pitfalls. Semin Pediatr Surg. 23(5):298-302, 2014
Trenor CC 3rd et al: Complex lymphatic anomalies. Semin Pediatr Surg. 23(4):186-90, 2014
Nadolski GJ et al: Thoracic duct embolization for nontraumatic chylous effusion: experience in 34 patients. Chest. 143(1):158-63, 2013
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Synonyms
Chylous fluid in pleural space
Definitions
Lymphatic fluid in pleural space secondary to congenital or acquired conditions, including obstruction, congenital anomaly, increased pressure, impaired drainage, or trauma to thoracic duct
Thoracic duct is major central lymphatic vessel
Extends in paraspinal tissues from cisterna chyli to point of drainage into left subclavian/brachiocephalic vein
Drains lymph from lower limbs, pelvis, abdomen
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
CT Findings
Lymphangiogram
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Brock WW et al: Congenital chylothorax: a unique presentation of nonimmune hydrops fetalis in a preterm infant. Adv Neonatal Care. 16(2):114-23, 2016
Bang JH et al: Anatomic variability of the thoracic duct in pediatric patients with complex congenital heart disease. J Thorac Cardiovasc Surg. 150(3):490-5, 2015
Bialkowski A et al: Congenital chylothorax: a prospective nationwide epidemiological study in Germany. Arch Dis Child Fetal Neonatal Ed. 100(2):F169-72, 2015
Krishnamurthy R et al: Imaging the central conducting lymphatics: initial experience with dynamic MR lymphangiography. Radiology. 274(3):871-8, 2015
Bengtsson BO: Outcome of neonatal chylous effusions: what do you tell the parents? A 10-year experience in a community hospital. Am J Perinatol. 31(12):1037-42, 2014
Downie L et al: Congenital chylothorax: associations and neonatal outcomes. J Paediatr Child Health. 50(3):234-8, 2014
Gray M et al: Treatment of congenital pulmonary lymphangiectasia using ethiodized oil lymphangiography. J Perinatol. 34(9):720-2, 2014
Lomauri Kh: Congenital chylothorax in newborn with trisomy 21. Georgian Med News. 74-7, 2014
Lopez-Gutierrez JC et al: Chylothorax and chylous ascites: management and pitfalls. Semin Pediatr Surg. 23(5):298-302, 2014
Trenor CC 3rd et al: Complex lymphatic anomalies. Semin Pediatr Surg. 23(4):186-90, 2014
Nadolski GJ et al: Thoracic duct embolization for nontraumatic chylous effusion: experience in 34 patients. Chest. 143(1):158-63, 2013
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