Isolated spontaneous chylopericardium during the treatment of non-Hodgkin's lymphoma / 대한내과학회지

ABSTRACT

Although malignant pericardial effusion is a common complication of malignancy, chylopericardium is a rare entity characterized by the accumulation of chylous fluid in the pericardial sac. The lymphatic vessels of the pericardium drain into the thoracic duct. The mechanical obstruction of venous drainage plays an important role in the pathophysiology of this disease. In most cases, pericardiocenthesis is needed to prevent cardiac tamponade. We present a case of a 15-year-old boy diagnosed as non-Hodgkin's lymphoma, diffuse large B cell, with superior vena cava syndrome, who developed an isolated chylopericardium after the first cycle of chemotherapy. We confirmed the diagnosis with an echocardiography, lymphangiography, and fluid analysis. Chylopericardium was managed successfully with pericardiocenthesis and drainage. If pericardial effusion were developed during the treatment of non-Hodgkin's lymphoma, chylopericardium should be considered as one of the differential diagnoses and associated venous thrombosis around the thoracic duct outlet should be ruled out.