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Cholesterol Pleural Effusion:  Report of 2 Cases Studied with Isotopic Techniques and Review of the World Literature

JOHN E. COE, M.D.; JERRY K. AIKAWA, M.D.
Arch Intern Med. 1961;108(5):763-774. doi:10.1001/archinte.1961.03620110103014.
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Cholesterol pleural effusion is a rarely reported condition characterized by a high concentration of lipid and, in most cases, cholesterol crystals in the pleural fluid. Although this entity was first described almost 80 years ago,1 a total of only 85 cases were found in a comprehensive review of the literature2 in 1951. Fourteen additional cases have been reported since then, but only one of these reports is in the English literature.3 The pathogenesis of this condition is unknown.

We have recently seen 2 cases of cholesterol pleural effusion and have performed various laboratory studies employing radioisotopes in an attempt to clarify the abnormal physiology involved.

Report of Cases 

Case 1.—  A 78-year-old white man, a retired construction worker, was admitted to Denver General Hospital on Nov. 13, 1958, with the chief complaints of cough, vague chest pain, dyspnea, and weakness. Until the onset of these symptoms 6

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