Diffuse large B-cell lymphoma with markedly improved chylothorax by lymphangiography

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  • MORIGUCHI Makoto
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • TAKAKUWA Teruhito
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • KAGEYAMA Ken
    Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University
  • OKAMURA Hiroshi
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • NANNO Satoru
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • NISHIMOTO Mitsutaka
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • NAKASHIMA Yasuhiro
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • KOH Hideo
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • NAKANE Takahiko
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • YAMAMOTO Akira
    Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University
  • NAKAMAE Hirohisa
    Department of Hematology, Graduate School of Medicine, Osaka City University
  • HINO Masayuki
    Department of Hematology, Graduate School of Medicine, Osaka City University

Bibliographic Information

Other Title
  • リンパ管造影により乳び胸水が著明に改善したびまん性大細胞型B細胞リンパ腫
  • リンパカンゾウエイ ニ ヨリ ニュウビ キョウスイ ガ チョメイ ニ カイゼン シタ ビマンセイ ダイ サイボウガタ Bサイボウ リンパシュ

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Abstract

<p>Chylothorax is a rare clinical sign in patients with diffuse large B-cell lymphoma (DLBCL), which is often challenging to manage and has a poor prognosis. We report the case of a 59-year-old woman who presented with right pleural effusion at the time of DLBCL diagnosis. Lymphadenopathy rapidly improved in response to chemotherapy. However, the pleural effusion progressed and was identified as chylothorax by thoracentesis. Because attempts to manage the condition with fasting and central venous nutrition were unsuccessful, we performed ultrasound-guided intranodal lipiodol lymphangiography from the inguinal lymph node. Although leak sites were not detected, the pleural effusion markedly improved on the day after the examination and resolved after 2 months. Lymphangiography is a minimally invasive examination with few complications. It contributes not only to the identification of leak sites but also to the improvement and resolution of chylothorax. Therefore, lymphangiography should be considered for refractory chylothorax that is unresponsive to chemotherapy or nutritional management.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 62 (6), 554-559, 2021

    The Japanese Society of Hematology

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