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Bilateral spontaneous chylothorax presenting as a left-sided neck mass
  1. Sarah Akbar1,
  2. Rajeev Advani2 and
  3. Rohini Aggarwal3
  1. 1Salford Royal Hospital, Salford, UK
  2. 2Royal Albert Edward Infirmary, Manchester, UK
  3. 3Salford Royal NHS Foundation Trust, Salford, UK
  1. Correspondence to Dr Sarah Akbar; sarah.akbar{at}doctors.org.uk

Abstract

A previously well 36-year-old woman presented with a 2-day history of a tender left-sided neck mass associated with left-sided otalgia and odynophagia. On examination, there was a diffuse, tender swelling of the left anterior triangle of the neck with extension onto the anterior chest wall. Ultrasound and CT scans of the neck revealed extensive inflammatory changes in the soft tissues of the neck and a chest X-ray showed blunting of both costophrenic angles. A diagnostic pleural aspiration was subsequently performed and yielded chyle. The patient was commenced on total parenteral nutrition and placed on a low-fat diet; symptoms completely resolved within 5 days, and at follow-up at 6 weeks, there were no further episodes or complications. Bilateral spontaneous chylothorax is a rarely reported phenomenon in the literature; it has been reported in females following the possibility of minor physical exercise such as stretching or hyperextension of the neck.

  • ear
  • nose and throat/otolaryngology
  • respiratory medicine

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Footnotes

  • Contributors SA is the main contributor for this piece of work, with the kind supervision of consultant ENT surgeon (RaA) and ENT speciality registrar (RoA). All work produced is original and with the full consent of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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