PMC8349037_01
(A) The nail color of the patient's right hand was yellow upon admission. (B) An enlarged view of the third and fourth fingers of the patient's right hand demonstrates the characteristic yellow coloration of YNS. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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Physical examination showed diminished breath sounds in the right middle and lower lung fields, significant edema in the lower extremities, and yellow discoloration of the fingernails (Fig. 1).
(A) Chest X-ray upon admission reveals bilateral pleural effusions. (B-E) Chest computed tomography reveals bilateral pleural effusions and ascites. Additionally, edema is visible in the right chest wall. (F) The plural effusion aspirated through thoracentesis upon admission demonstrates chylothorax.
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Chest X-ray and computed tomography (CT) showed bilateral pleural effusions (Fig. 2A-E) and CT also showed a large amount of ascites (Fig. 3A and B). The appearance of the pleural effusion was milky (Fig. 2F) and laboratory examination revealed that it was chylothorax (triglyceride concentration, 579 mg/dL), lymphocyte-predominant, and transudative (Table 1).
(A-B) Abdominal computed tomography reveals ascites. (C) Ascites aspirated through abdominocentesis upon admission demonstrates chylous ascites.
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The left pleural effusion and ascites were chylous, similar to the right pleural effusion (Fig. 3C).
A timeline demonstrating the clinical course and chest X-ray.
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Four months after discharge, the pleural effusion and ascites disappeared; the nail discoloration and lymphedema also resolved (Fig. 4).