CASE REPORT: FOLLICULAR LYMPHOMA PRESENTED WITH CHYLOTHORAX

Abstract

Chylothorax is the leakage of chylous contents into the pleural space as a result of damage to the thoracic duct. Chylous effusion is seen often unilateral but may be bilateral rarely. Etiology includes non-traumatic and traumatic causes. While sarcoidosis, amyloidosis, superior vena cava thrombosis and congenital anomalies are non-traumatic causes, non-Hodgkin lymphomas are the most common causes.Herein, we present a follicular lymphoma patient who was presented chylothorax at diagnosis. A 31-year-old male patient presented with fatigue, and dyspnea. On physical examination, inguinal and axillary multiple palpable lymphadenopathies (LAP) were observed, and respiratory sounds were significantly decreased on the left side.Computed tomography imaging revealed prevascular, paratracheal, subcarinal LAPs and 5 cm thick pleural effusion in the deepest part and compression atelectasison the left. Excisional LAP biopsy revealed follicular lymphoma When thoracentesis was performed and milky effusion was classified as an exudative. The high triglyceride level was consistent with a chylous effusion. After 6 cycles of R-CHOP treatment, the patient had a significant regression in the initial LAPs, while the chylous effusion persisted. When cytological examination of thoracentesis did not reveal lymphoma, the patient was followed-up. Chylothorax is associated with significant morbidity and mortality if left untreated. Control of the underlying malignancy is still the mainstay of treatment and reported as the most effective. In the literature, successful results were reported with the treatment of the underlying lymphoma. owever, it is known, chylothorax may recur and patients should be follow-up closely.