Open AccessChylothorax after endoscopic ultrasound with fine-needle aspiration causing migrating appearance of a solitary fibrous tumor of the pleura
Author(s) -
Francesco Mongelli,
Maurice FitzGerald,
Stefano Cafarotti,
Rolf Inderbitzi
Publication year - 2018
Publication title -
annals of thoracic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.639
H-Index - 33
eISSN - 1817-1737
pISSN - 1998-3557
DOI - 10.4103/atm.atm_340_17
Subject(s) - medicine , chylothorax , thoracotomy , pleural effusion , endoscopic ultrasound , radiology , fine needle aspiration , wedge resection , solitary fibrous tumor , mediastinum , chest tube , chest pain , surgery , biopsy , pneumothorax , resection , cd34 , genetics , stem cell , biology
Trans-esophageal endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is widely used to assess mediastinal masses. Common complications are self-limiting bleeding or pain, but occasionally, more serious accidents have been reported. A 54-year-old woman with a huge mass located in the left middle mediastinum presented 2 days after an EUS-FNA with dyspnea and chest pain. Computed tomography scan showed a massive left pleural effusion. A chest tube was inserted revealing a chylothorax (1800 ml). Over the following days, the pleural effusion did not diminish, requiring a left mini-thoracotomy. Intraoperative findings showed a pedunculated mass arising from the upper lobe. A wedge resection and a ligation of a large lymphatic vessel were performed. Postoperative course was regular. Histology showed a solitary fibrous tumor of the pleura. To our knowledge, the case we describe is the first reported chylothorax after EUS-FNA. Despite the demonstrated safety, particular care is mandatory in case of large, vascular, and heterogeneous masses.