Objective To explore the
diagnosis and
treatment of non traumatic
chylothorax in non-Hodgkin's lymphoma (NHL) and to understand the differences in
diagnosis and
treatment between
chylothorax and pseudochylothorax.
Methods The
patient aged 83 years was confrimed as
chylothorax and NHL after
lymph node biopsy.We reviewed
literatures about
chylothorax in NHL to analyse the possible mechanism,its
diagnosis and
treatment. Results The
patient was sufferring from unilateral
chylothorax diagnosed as true
chylothorax by
thoracentesis,and progressed to bilateral
chylothorax after 1 year.
PET/CT examination showed intrathoracic and right cervical
lymph nodes enlargement and an increasing metabolic activity.Cervical
lymph node biopsy revealed diffuse large B
cell type non-Hodgkin's lymphoma.The
patient refused any other
treatment except the
diet therapy and died after 19 months.We searched 19 cases with NHL
chylothorax in associated
literatures about the
treatments including
radiotherapy (6/6 improved),
chemotherapy (6/11 improved),
thoracic duct ligation (I/1 improved),
thoracic duct ligation and
drug pleurodesis(1/1 improved). Conclusions
PET/CT is useful in finding the hidden clues of
chylothorax in NHL.There is no standard mangement for NHL
chylothorax and the
treatment must be individualized. The overall
prognosis of NHL
chylothorax is
similar to that of non-Hodgkin's lymphoma and the
patient needs early diagnosis and general
treatment in order to prolong the
survival time.