{"title":"Diagnostic Dilemma of Milky Yellow Pleural Effusion.","authors":"Jiehua Han, Congcong Cheng, Qiongying Xu","doi":"10.7754/Clin.Lab.2025.250639","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chylothorax, a common complication post-lung cancer surgery, lacks standardized laboratory diagnostic criteria. Misdiagnosis remains prevalent due to variable pleural fluid appearance.</p><p><strong>Methods: </strong>We analyzed pleural fluid via biochemical tests, lipid profiling, and Sudan III staining. Ratios of effusion-to-serum triglycerides (P/S TG > 1) and cholesterol (P/S CHOL < 1) were applied to confirm chylous effusion.</p><p><strong>Results: </strong>The patient's pleural fluid exhibited milky yellow appearance, elevated TG (5.46 mmol/L), P/S TG ratio (3.62), and positive Sudan III staining. P/S CHOL ratio (0.43) and CHOL/TG (0.32) aligned with chylous criteria. Conservative management resolved the lymphatic leak.</p><p><strong>Conclusions: </strong>Integrating TG/CHOL ratios with Sudan III staining enhances diagnostic accuracy for chylothorax, reducing false negatives in non-milky effusions.</p>","PeriodicalId":10384,"journal":{"name":"Clinical laboratory","volume":"72 4","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical laboratory","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7754/Clin.Lab.2025.250639","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Chylothorax, a common complication post-lung cancer surgery, lacks standardized laboratory diagnostic criteria. Misdiagnosis remains prevalent due to variable pleural fluid appearance.
Methods: We analyzed pleural fluid via biochemical tests, lipid profiling, and Sudan III staining. Ratios of effusion-to-serum triglycerides (P/S TG > 1) and cholesterol (P/S CHOL < 1) were applied to confirm chylous effusion.
Results: The patient's pleural fluid exhibited milky yellow appearance, elevated TG (5.46 mmol/L), P/S TG ratio (3.62), and positive Sudan III staining. P/S CHOL ratio (0.43) and CHOL/TG (0.32) aligned with chylous criteria. Conservative management resolved the lymphatic leak.
Conclusions: Integrating TG/CHOL ratios with Sudan III staining enhances diagnostic accuracy for chylothorax, reducing false negatives in non-milky effusions.
期刊介绍：
Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.
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