吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (02): 404-407.doi: 10.13481/j.1671-587x.20180237

• 临床医学 • 上一篇    下一篇

感染引起淋巴结肿大致真性乳糜胸1例报告及文献复习

丛珊1, 门兰2, 刘伽莹1, 田畅1, 王珂1   

  1. 1. 吉林大学第二医院呼吸与危重症医学科, 吉林 长春 130041;
    2. 吉林大学中日联谊医院胃肠内科, 吉林 长春 130033
  • 收稿日期:2017-12-20 出版日期:2018-03-28 发布日期:2018-03-30
  • 通讯作者: 王珂,教授,主任医师,博士研究生导师(Tel:0431-81136820,E-mail:kewangm1@hotmail.com) E-mail:kewangm1@hotmail.com
  • 作者简介:丛珊(1992-),女,吉林省集安市人,在读医学硕士,主要从事肺部感染性疾病和肺癌诊治方面的研究。
  • 基金资助:
    吉林省科技厅科技成果转化项目资助课题(201603034YY)

True chylothorax induced by infection-caused lymphadenopathy: A case report and literature review

CONG Shan1, MEN Lan2, LIU Jiaying1, TIAN Chang1, WANG Ke1   

  1. 1. Department of and Critical Care Medicine, Second Hospital, Jilin University, Changchun 130041, China;
    2. Department of Gastroenterology, China-Japan Union Hospital, Jilin University, Changchun 130033, China
  • Received:2017-12-20 Online:2018-03-28 Published:2018-03-30

摘要: 目的:分析1例乳糜胸患者的临床诊治过程,并结合相关文献复习探讨乳糜胸的病因,以提高临床医生对乳糜胸罕见病因的认识。方法:1例女性患者,以咳嗽、胸痛及呼吸困难为首发症状,查体左侧颈部淋巴结肿大,胸部CT显示为双侧胸腔积液,胸水穿刺引流并送检化验,结果证实为乳糜胸。与乳糜胸产生相关的常见病因检查结果皆为阴性,最终临床诊断为感染性乳糜胸。给予抗感染治疗5d。结果:治疗后患者症状明显好转,复查胸腔彩超显示双侧胸腔积液已完全吸收,浅表肿大淋巴结缩小。1个月后随访症状消失,浅表淋巴结未触及,胸部CT未见异常。结论:对于临床上诊断困难的乳糜胸患者,应考虑到感染的可能,并给予积极抗感染治疗,避免漏诊、误诊和延误病情。

关键词: 淋巴结肿大, 胸腔积液, 病例报告, 感染, 乳糜胸

Abstract: Objective:To explore the etiology of chylothorax by analyzing the clinical data of one patient with chylothorax and combining with the review of relative literatures, and to improve the ability of clinicians for understanding the rare etiology of chylothorax. Methods: A young female with cough, chest pain and dyspnea as the first symptom was admitted to the hospital. Left lymph node enlargement in the neck of the patient was found in examination and bilateral pleural effusion was found in chest CT scanning. After puncture drainage and testing,the pleural effusion was confirmed the chylothorax.Since the examinations for common causes of chylothorax produced negative results, the patient was eventually diagnosed as infectious chylothorax. The patient received anti-infective therapy for 5 d. Results: After treatment, the symptoms of the patients were improved obviously; the pleural effusion disappeared, and the lymph nodes in the neck were shrink detected with chest color ultrasound. One month after follow-up, all the symptoms, enlarged lymph nodes and pleural effusion were recovered. There was no abnormity in chest CT. Conclusion: The possibility of infection should be considered in clinic for the patients with atypical chylothorax and anti-infective treatment should be performed in order to avoid the failed diagnosis and misdiagnosis.

Key words: case report, lymphadenopathy, chylothorax, pleural effusion, infection

中图分类号: 

  • R561