Chyloptysis with chylopericardium, a rare case and mini-review

BACKGROUND: Chyloptysis is reflux of chyle into the lungs and is a rare manifestation of primary chylous disorders. CASE PRESENTATION: Over 29 months, on the basis of x-rays, a 33-year-old female was repeatedly misdiagnosed with recurrent right-sided pneumonia; her symptoms included a recurrent cough, the appearance of cheese-like sputum, and diffuse pulmonary exudates. There was a history that abundant fluid in the pericardium was confirmed with echocardiography to have been present and asymptomatic for 4 years. Lymphangiography and surgery confirmed that the terminal portion of the thoracic duct was compressed by thick fibrous tissue and the vascular sheath of the internal jugular vein. Chyloptysis caused by high peribronchial lymphatic pressure was diagnosed and surgical intervention relieved the symptoms. CONCLUSION: Chyloptysis is rare and easy to misdiagnose but is a typical symptom of chylous reflux syndrome.