Brown-colored malignant pleural fluid with high bilirubin levels: a case series

Nai-Chien Huan and Larry Ellee Nyanti and Lee, Xin Ying and Hema Yamini Ramarmuty and Eng, Daniel Theng Sheng and Kunji Kannan Sivaraman Kannan and Lee, Gary Yun Chor (2024) Brown-colored malignant pleural fluid with high bilirubin levels: a case series. Case Reports in Pulmonology, 2024. pp. 1-4. ISSN 2090-6846

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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.

Item Type:	Article
Keyword:	Bilirubin, Brown-colored pleural,
Subjects:	R Medicine > R Medicine (General) > R5-920 Medicine (General) R Medicine > RC Internal medicine > RC31-1245 Internal medicine
Department:	FACULTY > Faculty of Medicine and Health Sciences
Depositing User:	SITI AZIZAH BINTI IDRIS -
Date Deposited:	16 Dec 2024 10:59
Last Modified:	16 Dec 2024 10:59
URI:	https://eprints.ums.edu.my/id/eprint/42162

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