Lymphoscintigraphy in a case of recurrent chylopericardium

Document Type : Case report

Authors

Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Abstract

Chylopericardium is an uncommon and benign condition in which triglyceride-containing chylous fluid collects in the pericardial cavity at high concentrations. Usually, chylopericardium occurs due to congenital malformation of lymphatic vessels or secondary to any trauma, surgeries, neoplasms, etc. However, if exact aetiology cannot be identified, the condition is referred to as Idiopathic chylopericardium which is a very rare presentation in day-to-day clinical practice. General physical examination, routine blood investigations and various anatomical imaging modalities may give a clue in the diagnosis, however, diagnosis can be challenging as they have a variable presentation. Also, optimal treatment poses greater difficulty as it remains controversial in most cases. We report a 47-year-old gentleman who presented with recurrent chylous pericardial effusion with no history of trauma, thoracic surgeries, cardiac disease and neoplasm in the past. Lymphoscintigraphy confirmed the communication between the lymphatic trunk and the pericardial space. The patient was managed conservatively with pericardial drainage and the patient recovered is doing well at present.

Keywords

References

  1. Dib C, Tajik AJ, Park S, Kheir MEL, Khandieria B, Mookadam F. Chylopericardium in adults: a literature review over the past decade (1996-2006). J Thorac Cardiovasc Surg. 2008 Sep; 136(3):650–6.
  2. Raza M, Matar K. Idiopathic chylothorax and chylopericardium resistant to conservative and surgical management. Heart Lung Circ. 2009 Jun; 18(3):229–32.
  3. Öztürk S, Durmuş G, Ağuş HZ, Koç HA, Can MM. A rare cause of pericardial tamponade: Chylopericardium. Anatol J Cardiol. 2017 Jun; 18(6):E11–2.
  4. Szuba A, Shin WS, Strauss HW, Rockson S. The Third Circulation: Radionuclide Lymphoscintigraphy in the Evaluation of Lymphedema. J Nucl Med. 2003 Jan 1; 44(1):43–57.
  5. Groves LK, Effler DB. Primary chylopericardium. N Engl J Med. 1954 Mar 25; 250(12):520–3.
  6. Wang C-H, Hung M-J, Cherng W-J, Yen T-C, Ng K-K, Lee C-M. Pedal 99mTc-Sulfur Colloid Lymphoscintigraphy in Primary Isolated Chylopericardium. Chest. 2000 Feb 1; 117(2):598–601.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 8, Issue 2
July 2020
Pages 157-159

Files

Share

How to cite

Statistics