Lipid pleural effusions

Am J Med Sci. 2008 Jan;335(1):16-20. doi: 10.1097/MAJ.0b013e31815d2634.


Traditionally, a lipid pleural effusion has been described as milky or turbid appearing. However, lipid effusions may have varied presentations making a diagnosis by appearance problematic. Distinguishing between a chylothorax and a cholesterol effusion, the 2 types of lipid effusions, is essential. A chylothorax develops after injury or obstruction of the thoracic duct, leading to a chyle leak into the pleural space that is characterized by an increased triglyceride concentration and the presence of chylomicrons. In contrast, a cholesterol effusion is a long-standing effusion associated with an elevated cholesterol concentration, usually greater than 250 mg/dL, a thick pleural rind, and represents a form of lung entrapment.

Publication types

  • Review

MeSH terms

  • Cholesterol / analysis*
  • Chylothorax* / diagnosis
  • Chylothorax* / etiology
  • Chylothorax* / physiopathology
  • Chylothorax* / therapy
  • Exudates and Transudates
  • Humans
  • Lipids / analysis*
  • Pleura / physiopathology
  • Pleural Effusion* / chemistry
  • Pleural Effusion* / diagnosis
  • Pleural Effusion* / physiopathology
  • Pleural Effusion* / therapy
  • Thoracic Duct / physiopathology


  • Lipids
  • Cholesterol