Brown-colored malignant pleural fluid with high bilirubin levels: a case series
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 b...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English English |
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John Wiley & Sons Ltd
2024
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| Subjects: | |
| Online Access: | https://eprints.ums.edu.my/id/eprint/42162/1/ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/42162/2/FULL%20TEXT.pdf |
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| author | Nai-Chien Huan Larry Ellee Nyanti Lee, Xin Ying Hema Yamini Ramarmuty Eng, Daniel Theng Sheng Kunji Kannan Sivaraman Kannan Lee, Gary Yun Chor |
| author_facet | Nai-Chien Huan Larry Ellee Nyanti Lee, Xin Ying Hema Yamini Ramarmuty Eng, Daniel Theng Sheng Kunji Kannan Sivaraman Kannan Lee, Gary Yun Chor |
| author_sort | Nai-Chien Huan |
| collection | UMS |
| description | 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. |
| first_indexed | 2025-03-05T01:34:07Z |
| format | Article |
| id | ums.eprints-42162 |
| institution | Universiti Malaysia Sabah |
| language | English English |
| last_indexed | 2025-03-05T01:34:07Z |
| publishDate | 2024 |
| publisher | John Wiley & Sons Ltd |
| record_format | dspace |
| spelling | ums.eprints-421622024-12-16T02:59:02Z https://eprints.ums.edu.my/id/eprint/42162/ Brown-colored malignant pleural fluid with high bilirubin levels: a case series Nai-Chien Huan Larry Ellee Nyanti Lee, Xin Ying Hema Yamini Ramarmuty Eng, Daniel Theng Sheng Kunji Kannan Sivaraman Kannan Lee, Gary Yun Chor R5-920 Medicine (General) RC31-1245 Internal medicine 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. John Wiley & Sons Ltd 2024 Article NonPeerReviewed text en https://eprints.ums.edu.my/id/eprint/42162/1/ABSTRACT.pdf text en https://eprints.ums.edu.my/id/eprint/42162/2/FULL%20TEXT.pdf 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 https://doi.org/10.1155/crpu/5807681 |
| spellingShingle | R5-920 Medicine (General) RC31-1245 Internal medicine Nai-Chien Huan Larry Ellee Nyanti Lee, Xin Ying Hema Yamini Ramarmuty Eng, Daniel Theng Sheng Kunji Kannan Sivaraman Kannan Lee, Gary Yun Chor Brown-colored malignant pleural fluid with high bilirubin levels: a case series |
| title | Brown-colored malignant pleural fluid with high bilirubin levels: a case series |
| title_full | Brown-colored malignant pleural fluid with high bilirubin levels: a case series |
| title_fullStr | Brown-colored malignant pleural fluid with high bilirubin levels: a case series |
| title_full_unstemmed | Brown-colored malignant pleural fluid with high bilirubin levels: a case series |
| title_short | Brown-colored malignant pleural fluid with high bilirubin levels: a case series |
| title_sort | brown colored malignant pleural fluid with high bilirubin levels a case series |
| topic | R5-920 Medicine (General) RC31-1245 Internal medicine |
| url | https://eprints.ums.edu.my/id/eprint/42162/1/ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/42162/2/FULL%20TEXT.pdf |
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