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Images of Memorable Cases: Case 154

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk

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Case_154-pres1-1.jpg

154. Yellow-Nail syndrome

This patient had a 20-year history of severe lymphedema of her legs; thick, ridged, yellowish, hypercurved thumbnails (top right); similarly affected, yellow-green to brown toenails (bottom right); and bilateral, chylous pleural effusions. A sample of her chylous pleural fluid is shown to the left of the radiograph. This syndrome of yellow nails, lymphedema, and pleural effusions (usually serous) presumably results from defective lymphatic drainage. Women are affected almost twice as much as men, and prolonged survival is the rule.

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