Massive chylothorax associated with lymphangiomatosis of the bone

J Pediatr Surg. 1994 Sep;29(9):1186-8. doi: 10.1016/0022-3468(94)90796-x.


Chylothorax in the absence of tumor or trauma is uncommon. Lymphangiomatosis of the bone, although extremely rare, has been associated with chylothorax. The authors describe the case of a 12-year-old boy who presented with a symptomatic left chylothorax associated with lymphangiomatosis of the ribs, scapula, and clavicle. Despite tube thoracostomies and the initiation of total parenteral nutrition, massive losses of chyle persisted, resulting in hypoproteinemia and severe lymphopenia. Control of the chylothorax was achieved by a parietal pleurectomy and application of fibrin glue (Tisseel). In the literature there are 16 cases of chylothorax associated with lymphangiomatosis of the bone. Their presentation, treatment, and outcome are reviewed. Conservative treatments such as dietary manipulations or thoracenteses were rarely successful. Thoracotomy with parietal pleurectomy on the side of the effusion is usually effective in controlling the chylothorax. Lymphangiomatosis should be considered a diagnostic possibility for any child who presents with a chylothorax.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / pathology
  • Bone Neoplasms / surgery*
  • Chest Tubes
  • Child
  • Chylothorax / diagnostic imaging
  • Chylothorax / pathology
  • Chylothorax / surgery*
  • Fibrin Tissue Adhesive / therapeutic use
  • Humans
  • Lymphangioma / diagnostic imaging
  • Lymphangioma / pathology
  • Lymphangioma / surgery*
  • Male
  • Pleura / diagnostic imaging
  • Pleura / surgery
  • Pleural Effusion, Malignant / diagnostic imaging
  • Pleural Effusion, Malignant / pathology
  • Pleural Effusion, Malignant / surgery*
  • Reoperation
  • Ribs / diagnostic imaging
  • Ribs / pathology
  • Ribs / surgery*
  • Thoracotomy
  • Tomography, X-Ray Computed


  • Fibrin Tissue Adhesive