title: Misdiagnosis of a chylous cyst as chest wall gouty tophus: a case of true pseudogout.
abstract: A patient referred to us for recurrent chest wall gouty tophus, but who was determined to actually have a chylous cyst, is described herein. Chylous cysts of the neck or chest wall can be caused by thoracic duct injury. Chyle contains 4-40 gm/liter of lipids, mostly triglycerides, and these can form birefringent crystals upon drying, leading to a false diagnosis of gout.
authors.affiliation: Geisinger Medical Center, Danville, Pennsylvania 17822, USA. lgadhikesavan@geisinger.edu
authors.forename: Leena G
authors.initials: LG
authors.lastname: Adhikesavan
authors.forename: William T
authors.initials: WT
authors.lastname: Ayoub
authors.forename: H Ralph
authors.initials: HR
authors.lastname: Schumacher
mesh_terms: D002805:Chondrocalcinosis / Q000175:diagnosis*; D002913:Chyle; D003560:Cysts / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006073:Gout / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013897:Thoracic Duct; D035441:Thoracic Wall