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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.
DOI: 10.7754/Clin.Lab.2025.250639
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