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Diagnostic Dilemma of Milky Yellow Pleural Effusion.

Clinical laboratory 2026 Vol.72(4)

Han J, Cheng C, Xu Q

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[BACKGROUND] Chylothorax, a common complication post-lung cancer surgery, lacks standardized laboratory diagnostic criteria.

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BibTeX ↓ RIS ↓
APA Han J, Cheng C, Xu Q (2026). Diagnostic Dilemma of Milky Yellow Pleural Effusion.. Clinical laboratory, 72(4). https://doi.org/10.7754/Clin.Lab.2025.250639
MLA Han J, et al.. "Diagnostic Dilemma of Milky Yellow Pleural Effusion.." Clinical laboratory, vol. 72, no. 4, 2026.
PMID 41979615

Abstract

[BACKGROUND] Chylothorax, a common complication post-lung cancer surgery, lacks standardized laboratory diagnostic criteria. Misdiagnosis remains prevalent due to variable pleural fluid appearance.

[METHODS] We analyzed pleural fluid via biochemical tests, lipid profiling, and Sudan III staining. Ratios of effusion-to-serum triglycerides (P/S TG > 1) and cholesterol (P/S CHOL < 1) were applied to confirm chylous effusion.

[RESULTS] The patient's pleural fluid exhibited milky yellow appearance, elevated TG (5.46 mmol/L), P/S TG ratio (3.62), and positive Sudan III staining. P/S CHOL ratio (0.43) and CHOL/TG (0.32) aligned with chylous criteria. Conservative management resolved the lymphatic leak.

[CONCLUSIONS] Integrating TG/CHOL ratios with Sudan III staining enhances diagnostic accuracy for chylothorax, reducing false negatives in non-milky effusions.

MeSH Terms

Humans; Pleural Effusion; Chylothorax; Triglycerides; Cholesterol; Male; Female; Lung Neoplasms; Middle Aged

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