PMC5283966_01
Chest X-ray and CT images on admission.
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A CT scan showed right pleural effusion and a right renal cyst without any lymphadenopathy (Fig. 1).
Appearance of pleural effusion.
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The pleural fluid was yellow and cloudy with a high concentration of triglycerides (576 mg/dL), especially chylomicron (28%) (Fig. 2).
Lymphoscintigraphy of the patient, left: anterior image; right: posterior image. Arrows indicate part of the obstruction.
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Lymphoscintigraphy showed an obstruction of the thoracic duct below the sternum (Fig. 3).
CD45-gated flow cytometry of pleural effusion. CD5: 99.5%, CD23: 70.0%, CD20: 45.3%, CD10: 0.5%.
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Given that the most frequent cause of chylothorax is malignant lymphoma, we performed CD45-gated flow cytometry of the pleural effusion and found increased numbers of CD5-positive (99.5%), CD23-positive (70.0%), CD20-positive (45.3%), and CD10-negative (0.5%) lymphocytes (Fig. 4).