Chylothorax due to leukemic infiltration in a patient with chronic lymphocytic leukemia

Tanrıverdi, Hakan; Uygur, Fırat; Tilkan, Osman Korcan; Gokce, Mertol; Tor, Meltem

doi:10.1016/j.rmcr.2015.09.006

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…The patient received no treatment, and chylothorax occurred during the observation period. As shown in this case, flow cytometric analysis of pleural fluid showed that cell surface markers including CD3, CD5, CD19, CD20 were positive, consistent with CLL, which confirmed that the chylothorax in our patient was associated with leukemic infiltration (10,13). The management of pleural effusion caused by hematological malignancies is challenging.…”

Section: Discussionsupporting

confidence: 78%

“…In general, the initiation of treatment depends on the Rai and Binet staging system and the presence of disease-related symptoms or not (10). Chylothorax, as a result of CLL, has only been reported in dozens of cases and rarely occurs during the late stage of the disease (12,13). Four months before the visiting to us, our patient was found to have multiple lymphadenopathies in the whole body during a routine physical examination and diagnosed with CLL/SLL in other hospital.…”

Section: Discussionmentioning

confidence: 99%

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Complete resolution of chylothorax with ibrutinib in chronic lymphocytic leukemia: a case report

Cheng¹,

Huang²,

Wei³

et al. 2022

Ann Palliat Med

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Chylothorax is an infrequent pleural effusion often caused by traumatic or nontraumatic injury to the thoracic duct. Nontraumatic chylothorax caused by chronic lymphocytic leukemia (CLL) is rarely reported. Previous experience has implied that the main factor affecting the treatment of chylothorax is whether the anti-cancer treatment is effective. The patient diagnosed with chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL) before the hospital admission, and not received any treatment.After four months, he had progressive dyspnea. Chest computed tomography (CT) scan showed bilateral pleural effusion with progressive lymphadenopathy, and massive chylous pleural effusion was drained by closed thoracic drainage. After a course of chemotherapy including fludarabine, cyclophosphamide and rituximab (FCR), the patient developed agranulocytosis and his pleural effusion was still abundant. After careful consideration, the patient refused to receive following chemotherapy and chose to take ibrutinib orally. Two months after oral ibrutinib, ultrasound examination showed that pleural effusion completely disappeared. In the next one year, the patient had a routine follow-up and was in good condition. To our knowledge, this is the first report of ibrutinib in the treatment of chylothorax associated with CLL. Ibrutinib provides a more palliative treatment for elderly CLL patients with chylothorax.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Complete resolution of chylothorax with ibrutinib in chronic lymphocytic leukemia: a case report

Cheng¹,

Huang²,

Wei³

et al. 2022

Ann Palliat Med

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“…[ 4 ] The most common cause of malignancy associated with chylothorax is lymphoma, which is present in over 70% to 75% of cases. [ 5 , 6 ] Chylothorax associated with germ cell tumors, as was the case in our patient, has previously not been reported.…”

Section: Discussionsupporting

confidence: 59%

Closure of the thoracic duct from the left-side access

Nachulewicz

Golonka²,

Żądkowski³

et al. 2016

Medicine

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Background:We report a 16-year-old patient with a massive left-sided chylothorax after chemotherapy due to mixed germinal tumor of the testis with massive metastases located in the retroperitoneal space and posterior mediastinum. Chemotherapy resolved the metastases in the mediastinum but evoked a huge pleural effusion in the left pleural cavity, requiring surgical intervention.Left-sided access was used. The 5-mm camera and 3 5-mm working ports were inserted. The parietal pleura was incised and the esophagus located and protected. Behind the esophagus, the thoracic duct and concomitant tissue were clipped with titanium clips, and additionally, thrombin glue was used. Stopping of the lymph leakage was observed during surgery. A local argon pleurodesis was used to finish the procedure. The thoracic tube was removed on the third postoperative day.Conclusion:Left-side access may be a good alternative in the left-sided chylothorax, but the crucial points are location and protection of the esophagus during the procedure, which is also the landmark that allows for locating the thoracic duct.

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“…Chylothorax may be caused by infections, pleural involvement and lymphatic obstruction, central catheterization and rarely by radiotherapy in patients with malignancies (3,4). Granulomatous infections such as tuberculosis and histoplasmosis have been reported as the cause of chylothorax by compressive or other effects of mediastinal lymphadenitis (5,6).…”

Section: Discussionmentioning

confidence: 99%

Bilateral Chylothorax: Which is to Blame?

Eyüboğlu¹,

Kaya

Gürkan

et al. 2017

GMJ

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Chylothorax is a rare condition in children with various traumatic and non traumatic etiologies. It is very important to determine the etiology for the management. Herein, we report a 16 year-old boy with a history of monosomy 7 positive refractory AML, stem cell transplantation, gastrointestinal graft versus host disease, invasive aspergillosis and bilateral chylothorax with multiple suspected etiologies.

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Chylothorax due to leukemic infiltration in a patient with chronic lymphocytic leukemia

Cited by 5 publications

References 8 publications

Complete resolution of chylothorax with ibrutinib in chronic lymphocytic leukemia: a case report

Complete resolution of chylothorax with ibrutinib in chronic lymphocytic leukemia: a case report

Closure of the thoracic duct from the left-side access

Bilateral Chylothorax: Which is to Blame?

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