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Images in Thorax
Wandering pulmonary shadows coinciding with pericardial and pleural effusions
  1. Yusaku Nishikawa1,
  2. Osamu Nishiyama1,
  3. Shigeki Shimizu2,
  4. Akiko Sano1,
  5. Yuji Tohda1
  1. 1 Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
  2. 2 Department of Pathology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
  1. Correspondence to Dr Osamu Nishiyama, Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan; nishiyama_o{at}

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Case presentation

A 43-year-old man was referred to a nearby hospital because of exertional dyspnoea. Chest radiography revealed an enlarged heart and bilateral lower lung infiltrates (figure 1A). Chest CT revealed bilateral basal pulmonary consolidations, pericardial effusion and small amounts of pleural effusion bilaterally (figure 1B). He was referred to our hospital and underwent pericardiocentesis. Because of a high triglyceride concentration in the pericardial effusate (1287 mg/dL), the patient was diagnosed with chylopericardium. He was prescribed a low-fat diet with subsequent resolution of the pericardial effusion and exertional dyspnoea. Although the bilateral consolidations on chest CT also resolved (figure 1C), on the following year, ground-glass opacities appeared, mainly in the right upper lobe and right S6 (figure 1D). The patient’s physical examination and blood test results were unremarkable. His pulmonary function tests were normal. The findings of bronchoalveolar lavage fluid obtained from …

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  • Contributors YN contributed to patient management. ON conceived the idea for the case report. YN and ON drafted the initial manuscript. SS are responsible for pathological findings. ON and AS critically reviewed the manuscript. YT approved the final version of the manuscript.

  • 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.

  • Patient consent for publication Obtained.

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

  • Data availability statement There are no data in this work.

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