CHEST 2023 On Demand Pass-The Pleura: One Enigmatic Space, Multiple Riveting Diagnoses

Video Transcription

Video Summary

The case involves a 67-year-old male who presented with dyspnea and decreased appetite. He had a history of hypertension, hyperlipidemia, CKD, and benign prostatic hyperplasia. Initial chest x-ray showed a complete opacification of the right lung with a large right-sided pleural effusion. Thoracentesis was performed and a chest tube was placed. The fluid analysis revealed chylothorax. A CT scan showed a lung mass and a biopsy was negative for malignancy. The patient underwent VATS and pleurodesis. A PET-CT scan showed tracer uptake in the right lobe of the thyroid gland and a thyroid nodule. A biopsy confirmed papillary thyroid carcinoma. The patient underwent thyroidectomy and followed up PET scans showed no further tracer uptake. Chylothorax is a rare complication of thyroid surgery and usually occurs after modified radical neck dissection of thyroid carcinoma. This case is unique as the patient presented with chylothorax before any thyroid intervention. The presentation of chylothorax due to compression of the thoracic duct by thyroid cancer is rare. Most cases are reported in follicular or papillary carcinoma.

Meta Tag

Category Disorders of the Pleura

Session ID 4011

Speaker Esther Chen Etchison

Speaker Janessa Haasbeek

Speaker Ashma Ul Husna

Speaker Ian Mahoney

Speaker Ayman Mohamed

Speaker Andrei Schwartz

Track Disorders of the Pleura

Keywords

dyspnea

chylothorax

thyroid carcinoma

pleural effusion

biopsy

PET-CT scan

thoracic duct