Brown-Colored Malignant Pleural Fluid With High Bilirubin Levels: A Case Series.

Q4 Medicine Case Reports in Pulmonology Pub Date : 2024-11-18 eCollection Date: 2024-01-01 DOI:10.1155/crpu/5807681
Nai-Chien Huan, Larry Ellee Nyanti, Xin Ying Lee, Hema Yamini Ramarmuty, Daniel Theng Sheng Eng, Kunji Kannan Sivaraman Kannan, Yun Chor Gary Lee
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Abstract

Brown-colored pleural effusion is rare and may result from high bilirubin levels such as bilothorax (often described as a pleural fluid-to-serum bilirubin ratio of > 1.0). We describe four patients with malignant pleural effusion that appeared macroscopically brown with a pleural fluid-to-serum bilirubin ratio between 3.7 and 16.2. All had metastatic adenocarcinomas; three were from lung and one from gastric origin. None demonstrated clear pleurobiliary fistulas on investigations. Postulates for the development of brown effusion include heme oxygenase 1 overexpression in malignant cells situated in the pleura, intrapleural hemolysis, passive movement of bile through microscopic diaphragmatic pores, and drainage of biliary fluid into the pleural lymphatics.

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高胆红素水平的棕色恶性胸腔积液:病例系列。
棕色胸腔积液非常罕见,可能是胆红素水平过高造成的,例如胆气胸(通常描述为胸腔积液与血清胆红素比值大于 1.0)。我们描述了四名恶性胸腔积液患者,他们的胸腔积液在宏观上呈棕色,胸腔积液与血清胆红素的比值介于 3.7 和 16.2 之间。所有患者均为转移性腺癌,其中三例来自肺部,一例来自胃部。检查结果均未显示明确的胸胆管瘘管。棕色渗出的推测包括位于胸膜的恶性细胞中血红素加氧酶1过度表达、胸膜内溶血、胆汁通过微小的膈孔被动移动以及胆汁排入胸膜淋巴管。
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来源期刊
Case Reports in Pulmonology
Case Reports in Pulmonology Medicine-Pulmonary and Respiratory Medicine
CiteScore
1.80
自引率
0.00%
发文量
23
审稿时长
13 weeks
期刊最新文献
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