Misdiagnosis of a chylous cyst as chest wall gouty tophus: a case of true pseudogout.
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.
Adhikesavan
Leena G
LG
Geisinger Medical Center, Danville, Pennsylvania 17822, USA. lgadhikesavan@geisinger.edu
Ayoub
William T
WT
Schumacher
H Ralph
HR
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