Chylopericardium caused by non-small cell lung cancer: a rare complication of superior vena cava syndrome.

摘要

Chylopericardium represents a communication between the pericardial cavity and the lymphatics. We report the first case of chylopericardium caused by lung cancer with superior vena cava (SVC) syndrome. A previously healthy, 77-year-old Japanese man was presented with a 2-week history of worsening dyspnea. At presentation, he was in respiratory distress and orthopneic. Blood pressure was 154/80 mmHg without paradoxical pulses, respiratory rate was 16 per minute, and the oxygen saturation was 97% with supplemental oxygen (3 L) by nasal cannula. The face and upper extremities were edematous. Computed tomography of the chest and echocardiography showed moderate amounts of pericardial effusion but no signs of tamponade (Figure 1A). Chylous effusion of 500 mL was drained by pericardiocentesis, and dyspnea was relieved. Analysis of the pericardial effusion revealed total protein at 5.2 g/dL, total cholesterol 212 mg/dL, and triglyceride 806 mg/dL.