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. 2014:2014:684689.
doi: 10.1155/2014/684689. Epub 2014 May 7.

Rapid decline of follicular lymphoma-associated chylothorax after low dose radiotherapy to retroperitoneal lymphoma localization

Lien Van De Voorde  1 , Ben Vanneste  1 , Jacques Borger  1 , Esther G C Troost  1 , Philo Werner  2
Affiliations

Rapid decline of follicular lymphoma-associated chylothorax after low dose radiotherapy to retroperitoneal lymphoma localization

Lien Van De Voorde et al. Case Rep Hematol. 2014.

Abstract

Chylothorax is caused by disruption or obstruction of the thoracic duct or its tributaries that results in the leakage of chyle into the pleural space. A number of interventions have been used to treat chylothorax including the treatment of the underlying disease. Lymphoma is found in 70% of cases with nontraumatic malignant aetiology. Although patients usually have advanced lymphoma, supradiaphragmatic disease is not always present. We discuss the case of a 63-year-old woman presenting with progressive respiratory symptoms due to chylothorax. She was diagnosed with a stage IIE retroperitoneal grade 1 follicular lymphoma extending from the coeliac trunk towards the pelvic inlet. Despite thoracocentesis and medium-chain triglycerides (MCT), diet chylothorax reoccurred. After low dose radiotherapy (2 × 2 Gy) to the abdominal lymphoma there was a marked decrease in lymphadenopathy at the coeliac trunk and a complete regression of the pleural fluid. In this case, radiotherapy was shown to be an effective nontoxic treatment option for lymphoma-associated chylothorax with long-term remission of pleural effusion.

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Figures

Figure 1
Figure 1
Chest X-ray before radiotherapy: large amount of pleural fluid (right) (a) with complete remission 3 months after radiotherapy on CT thorax (b).
Figure 2
Figure 2
CT abdomen shows a confluent lymphoma mass commencing at the celiac trunk and extending inferiorly to the pelvic outlet (a) before and (b) after radiotherapy.
Figure 3
Figure 3
3D dose distribution for radiotherapy planning of abdominal lymphoma.
See this image and copyright information in PMC

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