Transudative Chylothorax: Two Case Reports and Review of the Literature

Chylothorax is uncommon and transudative chylothorax is even rarer. In contrast to exudative chylothorax, the most common etiologies of transudative chylothorax are liver cirrhosis, congestive heart failure, nephrotic syndrome and superior vena cava thrombosis. We present 2 case reports of transudative chylothorax: The first case describes a man who had shortness of breath and orthopnea for 3 days, mimicking congestive heart failure. After a series of workups, nephrotic syndrome-related chylothorax was diagnosed, and diuretics and a low-salt diet were prescribed. No recurrence of dyspnea was noted during 1 year of followup. The second case involved a woman that suffered from progressive dyspnea for 2 months. After a thoracentesis study, we ruled out congestive heart failure and nephrotic syndrome. Liver cirrhosis-related chylothorax was later confirmed. However, the patient's symptoms recurred, even after receiving diuretic treatment and with low-salt diet control. We also reviewed the medical literature to remind clinicians of the importance of avoiding unnecessary workups if chylothorax is transudative.