Spontaneous chylothorax in a patient with a cutaneous lymphangioma.

A 66-year-old man with a cutaneous lymphangioma spontaneously developed chylothorax responsible for chest pain, exertional dyspnea, and a cough. Thoracentesis recovered a chylous culture-negative fluid that contained no tumor cells. A pleural biopsy specimen obtained under thorascopic guidance failed to reveal any specific lesions or evidence of tumor. Computed tomography scans of the chest and abdomen, lymphography, and a three-year follow-up failed to identify the causative lesion. Talc poudrage through a thorascopic cannula was effective in drying up the effusion.