title: Massive bilateral chylothoraces complicating mediastinal granulomatous disease.
abstract: Mediastinal granulomatous disease with resulting fibrosis is known to cause several serious complications, including pulmonary artery occlusion, bronchial stenosis, superior vena cava syndrome, and constrictive pericarditis. This process is typically the result of an excessive fibrogenic response to the antigen of the fungus Histoplasma capsulatum. We present a case of a 20-year-old man who had massive bilateral chylothoraxes develop as a complication of mediastinal granulomatous disease. Aggressive surgical therapy was necessary to treat this potentially life-threatening condition with an excellent result.
authors.affiliation: Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Felix G
authors.initials: FG
authors.lastname: Fernandez
authors.forename: Chadrick E
authors.initials: CE
authors.lastname: Denlinger
authors.forename: G Alexander
authors.initials: GA
authors.lastname: Patterson
authors.forename: Daniel
authors.initials: D
authors.lastname: Kreisel
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Krupnick
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000601:surgery; D002114:Calcinosis / Q000473:pathology; D015505:Chest Tubes; D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005355:Fibrosis / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006099:Granuloma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006658:Histoplasma; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008477:Mediastinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008481:Mediastinoscopy; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D013897:Thoracic Duct / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult