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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 fluidis shown to the left of the radiograph. This syndrome of yellow nails, lymphedema, and pleural effusions (usually serous) presumably results fromdefective lymphatic drainage. Women are affected almost twice as much as men, and prolonged survival is the rule.
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