chylothorax, pseudochylothorax 감별
- 최초 등록일
- 2012.09.14
- 최종 저작일
- 2012.04
- 1페이지/ MS 워드
- 가격 1,000원
소개글
chylothorax와 pseudochylothorax의 감별진단입니다.
한눈에 알아보기 쉽게 정리되어있습니다.
목차
Chylothorax
Leakage of thoracic duct lymph or chyle into the pleural space (disruption or obstruction of the thoracic duct)
Causes
1. Trauma : Surgical procedures
2. Tumor invasion of thoracic duct
lymphoma (70%), lung cancer
3. Granulomatous dz ex) tbc : mediastinal lymphadenitis
4. Mediastinal fibrosis
5. chylous ascites (lymphoma, cirrhosis, congenital lymphatic abnormalities) leaks across the diaphragm
6. Idiopathic
본문내용
Leakage of thoracic duct lymph or chyle into the pleural space (disruption or obstruction of the thoracic duct)
Causes
1. Trauma : Surgical procedures
2. Tumor invasion of thoracic duct
lymphoma (70%), lung cancer
3. Granulomatous dz ex) tbc : mediastinal lymphadenitis
4. Mediastinal fibrosis
5. chylous ascites (lymphoma, cirrhosis, congenital lymphatic abnormalities) leaks across the diaphragm
6. Idiopathic
Diagnostic approach
1. CXR – pleural effusion
thoracentesis, chest tube : milky, opalescent (50%)
Chylothorax Pseudochylothorax
Appearance Milky Milky to greenish
Microscopic Lymphocytes
Fine fat droplet Mixed
Cholesterol crystal
TG 2~8배 <serum
Cholesterol <serum >serum
Lipoprotein EP Chylomicon Scant chylomicron
Etiology Thoracic duct
Obstruction Cell membrane
breakdown
2. pleural fluid analysis
Chylous fluid
Milky exudate
Cf) transudative chylothorax (amyloidosis, cirrhosis,
nephrotic syndrome, SVC obstruction, HF,
chylous ascites)
Lipid content 1-4g/dl
주로 neutral fat and fatty acid
TG > 110 mg/dl : chylothorax
TG 50-110 mg/dl
lipoprotein EP에서 chylomicron (+)
TG < 50 mg/dl - Pseudochylothorax
Cholesterol↓
3. chest CT : site of leakage
4. lymphangiography : CT상에서 안 보이면
5. labarotary testing : underlying dz
참고 자료
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