Massive Bilateral Chylothoraces Complicating Mediastinal Granulomatous Disease

Mediastinal granulomatous disease with resulting fibrosis is known to cause several serious complications, including pulmonary artery occlusion, bronchial stenosis, superior vena cava syndrome, and constrictive pericarditis. This process is typically the result of an excessive fibrogenic response to the antigen of the fungus Histoplasma capsulatum. We present a case of a 20-year-old man who had massive bilateral chylothoraxes develop as a complication of mediastinal granulomatous disease. Aggressive surgical therapy was necessary to treat this potentially life-threatening condition with an excellent result. (Ann Thorac Surg 2009;88:1012-3) (C) 2009 by The Society of Thoracic Surgeons