Chylous Effusion Complicating Chronic Lymphocytic Leukemia

Abstract

We present a case of chylous effusion (CE) occurring in a patient with chronic lymphocytic leukemia (CLL), an observation which has rarely been reported. Therefore, CLL should be added to the differential diagnosis of nontraumatic chylothorax. CE in CLL can be successfully managed by irradiation of the mediastinum.

Persisting right-sided chylothorax in a patient with chronic lymphocytic leukemia: a case report

“…Whether the prognosis for these patients might improve with modern immunochemotherapy remains to be seen. It is also interesting to note that patients with longer reported survival had either successful thoracic duct ligation, mediastinal irradiation or pleurodesis [11,12,17]. In our opinion, this allows for the conclusion that treating physicians should aim for definitive resolution of the chylothorax.…”

“…However, mediastinal irradiation can be effective in CLL-associated chylothorax, as demonstrated by Ampil et al , who reported the case of a female CLL patient who developed chylothorax under continuous treatment with chlorambucil and prednisone. Following mediastinal irradiation with 1000 cGy over five days, her chylous effusion resolved during the nearly five years of follow-up [17]. …”

Bilateral Chylothorax Complicating a Case of Chronic Lymphocytic Leukemia: A Case Report

“…CLL is a rare cause of chylothorax, and has only been reported in a few other instances. 6-8 Bilateral chylothorax is even rare and has not been frequently reported so far. 9 Usually, the patient with chylothorax remains asymptomatic until a large amount of chyle accumulates in the pleural space.…”

“…In another case, the chylothorax was successfully treated with mediastinal irradiation. 6 For our patient, we opted for initial treatment with chemotherapy with the intention to reduce the number of tumor cells and relieve the pseudo obstruction of pleural lymphatics. Currently the patient continues with chest tube drainage on right side and intermittent thoracentesis on left side.…”

Extramedullary relapse in a child with mixed lineage acute lymphoblastic leukemia: Chylous pleuropericardial effusion

“…Although such complications have been described in adults with lymphoma and chronic lymphatic leukemia, [1,2] no cases have been reported in children with acute lymphoblastic leukemia (ALL). Our patient, a three-year-old Saudi boy with ALL who developed a malignant chylous pleuropericardial effusion may therefore be instructive.…”