MEDICAL CHYLOTHORAX AN ACUTE FINDING OF AN AGGRESSIVE LYMPHOMA

TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: Chylothorax is a rare complication usually seen in Non-Hodgkin Lymphomas as enlarged mediastinal lymph nodes can compress the thoracic duct. Quick diagnosis important since condition be fatal if left untreated. Persistent loss of chyle could lead to malnutrition, weight and immunosuppression. CASE PRESENTATION: 35y/o man with worsening SOB fatigue for one month. Associated night sweats, intermittent dry cough, anorexia, back pain. Denied fever, chills, loss, emesis or diarrhea. No pertinent past medical but has 4 pack-year smoking history. Findings on physical exam included tachycardia, tachypnea, bilateral inguinal lymphadenopathy, decreased right lung sounds dullness percussion. Chest CT detailed an anterior mass, axillary nodes, right-sided pleural effusion. The patient was taken surgery chest tube placement node biopsy. Pleural fluid initially drained serosanguinous which then turned into milky white fluid. analysis showed 112mg/dl triglycerides 48mg/dl cholesterol, suggestive chylothorax. T-Cell Lymphoblastic Lymphoma diagnosed. Patient discharged after chemotherapy removed chylothorax resolved. DISCUSSION: Diagnosis chylous effusion based presence chylomicrons triglyceride levels >110mg/dl, chylomicrons, low cholesterol level, elevated lymphocyte count are diagnostic In our case, were aggressive lymphoma. Dietary modifications low-fat high-protein diet suitable patients volume Somatostatin infusions used adjuvant therapy they have been similarly reduction intestinal production leak. Nevertheless, when managing large leaks, particularly exceeding 1.5 liters per day, early surgical intervention warranted. CONCLUSIONS: This case highlights importance proper recognition rapid treatment lymphomas order prevent nutritional status immunocompetency may adversely affect prognosis. REFERENCE #1: Khosravi, A., & Anjidani, A. (2009). Spontaneous recovery caused by Hematology/Oncology Stem Cell Therapy, 2(3), 431-434. #2: Kumar, Harris, K., Roche, C., Dhillon, S. (2014). A 69-Year-Old Woman Chylothorax. Looking Beyond Usual Suspect. Annals American Thoracic Society, 11(9), 1490-1493. #3: Nair, Petko, M., Hayward, M. P. (2007). Aetiology management adults. European Journal Cardiothoracic Surgery, 32(2), 362-369. DISCLOSURES: relevant relationships Maria Irizarry Zapata, source=Web Response Carlos Martinez Crespi, Joel Rodriguez Ramos, Melissa Vega, Lisselle Villarrubia Ocasio,