A 76-year-old woman presented with worsening dyspnea for the past 4 weeks with dyspnea, worsening fatigue and weight loss. On examination, she has generalized lymphadenopathy. CXR shows moderate left-sided pleural effusion. A thoracentesis is performed, revealing milky fluid. Pleural fluid is exudative effusion with cell count 4800/mm3 with 14% neutrophils, 12% mesothelial cells, and 74% lymphocytes. Pleural fluid triglyceride is 170 mg/dL. What is the likely cause of this patient's illness?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Lymphoma
Milky, lymphocyte-predominant exudate with triglyceride >110 mg/dL = chylothorax. With generalised lymphadenopathy, weight loss and fatigue, the cause is lymphoma blocking the thoracic duct. TB and lung cancer give lymphocytic exudates but not chyle; parapneumonic effusions are neutrophilic.
ليش كل خيار صح أو غلط
-
A
ليش غلط
TB-related chronic pleural inflammation gives a pseudochylothorax (cholesterol-rich, triglycerides below 110 mg/dL); this fluid has triglycerides of 170.
✓ Pleural effusion.pdf · p. 8 -
B
ليش غلط
A malignant effusion is described as cloudy or straw-coloured or bloody with abnormal cytology; milky fluid with triglycerides above 110 is chylothorax, whose listed malignant cause is lymphoma.
✓ Pleural effusion.pdf · p. 8 -
C
ليش صح
Milky, lymphocyte-predominant exudate with triglycerides above 110 mg/dL is chylothorax, and its listed malignant cause is lymphoma, matching the generalised lymphadenopathy.
✓ Pleural effusion.pdf · p. 8 -
D
ليش غلط
An acute illness such as pneumonia gives a neutrophil predominant fluid; this fluid is 74% lymphocytes, as in chronic illnesses such as lymphoma and chylothorax.
✓ Pleural effusion.pdf · p. 5
- المصدر
- Pleural effusion.pdf · p. 8
- المحاضرة
- Pleural Effusion & Pneumothorax · Pulmonology · Module B
- ظهر في
- Respi bank