Non‐Hodgkin lymphoma manifesting as massive malignant chylothorax: successful management with chemotherapy and ambulatory drainages using indwelling pleural catheter

Abstract

Recurrent cancer-related chylothorax is generally managed by talc pleurodesis or indwelling pleural catheter in the palliative care setting to relieve symptoms and improve quality of life. In chylothorax associated with curable/treatable malignancies like lymphoma, there are scarce data regarding the efficacy and safety of indwelling pleural catheters. We report a case of recurrent massive chylothorax associated with non-Hodgkin lymphoma who demonstrated long-term remission of lymphoma and complete regression of chylothorax after treatment with combination chemotherapy and ambulatory drainages using indwelling pleural catheter.

Experiences in the treatment of refractory chylothorax associated with lymphoproliferative disorders

“…Ninety percent of the occurrence of chylothorax was linked to the activity of malignant lymphoproliferation accompanied by mediastinal lymphadenopathy and/or the presence of cancer cells in chylous effusion. The effective treatment of the malignant disease usually also resulted in the clearance of chylous secretion [1, 12]. The second progression of chylothorax was unclear in one patient only (10%), which was associated with the completed radiotherapy of para-aortic and mediastinal lymph nodes.…”

“…The treatment of chylothorax is usually long and depends on the type of chylothorax, its duration, extent of chyle loss, and the overall condition of the patient. It appears that the crucial measures in the treatment of malignant chylothorax include effective cancer therapy [2, 12, 15] and supplementary interventions like parenteral nutrition, the management of concomitant infectious complications as well as rehabilitation [8].…”

Clinical Characteristics of Diabetes Mellitus and Suicide Risk

“…Davis and colleagues (19), by investigating the suicide risk and associated factors in an older diabetic Australian population, found also that if suicide is a rare event among diabetic adults, compared to the general population, a higher occurrence appeared in subjects with T1DM and a greater diabetes-related disease burden. A bivariate comparison showed also a significant association between suicide with higher presence of retinopathy and greater antidepressant use.…”

“…When taking into consideration, the duration of DM as a risk factor for suicide, several studies have investigated the incidence of suicidal behavior (i.e., ideation, attempts, and acts) among adults and elderly patients with T1DM (12, 19). Other studies have highlighted that T1DM patients were three to four times more likely to attempt suicide during their lifetime than subjects without DM (18) and that a higher occurrence appeared in subjects with T1DM and a greater diabetes-related disease burden (10, 19).…”

“…Other studies have highlighted that T1DM patients were three to four times more likely to attempt suicide during their lifetime than subjects without DM (18) and that a higher occurrence appeared in subjects with T1DM and a greater diabetes-related disease burden (10, 19). …”