Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma

Papa Ousmane Ba; Myriam Bizrane; Souleymane Diatta; Jean Claude Ndiogou Dione; Momar Sokhna Diop; Papa Amath Diagne; Kondo Bignandi; Mory Camara; Marème Soda Mbaye; Papa Adama Dieng; Amadou Gabriel Ciss; Assane Ndiaye

doi:doi:10.11648/j.ijcts.20230903.13

Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma

Papa Ousmane Ba, Myriam Bizrane, Souleymane Diatta, Jean Claude Ndiogou Dione, Momar Sokhna Diop, Papa Amath Diagne, Kondo Bignandi, Mory Camara, Marème Soda Mbaye, Papa Adama Dieng, Amadou Gabriel Ciss, Assane Ndiaye

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 3)

Received: 26 May 2023 Accepted: 19 June 2023 Published: 27 June 2023

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Abstract

Introduction: Chylous effusions are rare and their etiologies are multiple and diverse. Chylothorax is the most common; however, chylopericardium is exceptional. The aim of this work is to report the epidemiological, diagnostic and therapeutic aspects of Hodgkin lymphoma revealed by chylopericardium and bilateral chylothorax with review of the literature. Case presentation: It’s about a 34 years old man, with no particular pathological history, admitted in emergency, with a cardiac tamponade associated with a bilateral pleural effusion. The patient underwent a subxiphoid pericardiostomy and pleural drainage, removing milky pericardial (800cc) and pleural (1850cc) fluid. Fluid analysis confirmed a chylous effusion with no malignant cells. The patient was started on a low dietary fat diet which allowed a decrease in the chyle output after 10 days. A mediastinal mass biopsy was performed, through an anterior right mediastinotomy, revealing a Hodgkin lymphoma. The patient was referred to an Oncology center and underwent a full course of chemotherapy. The patient’s response to chemotherapy was favorable with a good clinical outcome and complete regression of the superior vena cava syndrome, the edema and the respiratory distress. Conclusion: It’s important to keep in mind some uncommon presentations of mediastinal tumors in general, and specifically Hodgkin Lymphoma; as well as the role of the 3 cornerstones (low-fat diet, surgery, and treatment of the underlying cause) in the management of this condition.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 3)
DOI	10.11648/j.ijcts.20230903.13
Page(s)	32-35
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Chylopericardium, Chylothorax, Lymphoma, Mediastinal Tumor

References

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[2]	N Milandt, T Birkelund M Engholm Acute Chylopericardium with Tamponnade and Cardiac Arrest with pseudomyxoma Peritonei. Am J Cardiol 2021; 146: 134-136.
[3]	Wijaya S Y, Koesoemoprodjo W Indonesian female with bilateral chylothorax and mediastinal non-Hodgkin lymphoma: a case report. Int J Surg Case Report. 2023 Jan; 102: 107827. doi: 10.1016/j.ijscr.2022.107827.
[4]	Petrini M, Colombi D, Bodini F G and al Thoracic duct leakage in a patient with Type B-Non-Hodgkin lymphoma treated with transvenous retrograde access embolization: a case report. Acta Biomed 2023 Jan 31; 94 (S1): e2023043. doi: 10.23750/abm.v94iS1.12732.
[5]	Doerr CH, Allen MS, Nichols FC, Ryu JH. Etiology of chylothorax in 203 patients. Mayo Clin Proc. 2005; 80 (7): 867-870. doi: 10.4065/80.7.867.
[6]	Rochefort MM. Review of chylopericardium. Mediastinum. 2022; 6: 6-10. doi: 10.21037/MED-20-64.
[7]	O’donnell J, Kirkham J, Monteith D, Frontario C, Sharma R, Higgins B. Chylous Cardiac Tamponade with Chylothoraces Secondary to Hodgkin’s Lymphoma: Octreotide in Conjuncture with Standard of Care Dietary Fat Restriction. Case Reports Crit Care. 2019; 2019: 6-9. doi: 10.1155/2019/1406840.
[8]	Verma SK, Karmakar S. Hodgkin’s lymphoma presenting as chylothorax. Lung India. 2014; 31 (2): 184-186. doi: 10.4103/0970-2113.129883.
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[10]	Alsagaff MY, Laksmi NPA, Maghfirah I, Susilo H. Tamponade with recurrent chylopericardium in patient with non-Hodgkin's lymphoma: chemotherapy is the key management after pericardiocentesis. BMJ Case Rep. 2022 May 17; 15 (5): e249675. doi: 10.1136/bcr-2022-249675.
[11]	Bender B, Murthy V, Chamberlain RS. The changing management of chylothorax in the modern era. Eur J Cardio-thoracic Surg. 2016; 49 (1): 18-24. doi: 10.1093/ejcts/ezv041.
[12]	Janjetovic S, Janning M, Daukeva L and al Chylothorax in a patient with Hodgkin's lymphoma: a case report and review of the literature. Tumori 2013 May-Jun; 99 (3): e96-9. doi: 10.1177/030089161309900324.
[13]	O’Callaghan AM, Mead GM Chylothorax in lymphoma: Mechanisms and management. Ann Oncol, 1995; 6: 603-607.
[14]	Gurevich A, Hur S, Singhal S, DiBardino D, Haas AR, Hansen-Flaschen JH, Nadolski G, Itkin M. Nontraumatic Chylothorax and Chylopericardium: Diagnosis and Treatment Using an Algorithmic Approach Based on Novel Lymphatic Imaging. Ann Am Thorac Soc. 2022 May; 19 (5): 756-762. doi: 10.1513/AnnalsATS.202103-262OC.
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APA Style

Papa Ousmane Ba, Myriam Bizrane, Souleymane Diatta, Jean Claude Ndiogou Dione, Momar Sokhna Diop, et al. (2023). Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma. International Journal of Cardiovascular and Thoracic Surgery, 9(3), 32-35. https://doi.org/10.11648/j.ijcts.20230903.13

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ACS Style

Papa Ousmane Ba; Myriam Bizrane; Souleymane Diatta; Jean Claude Ndiogou Dione; Momar Sokhna Diop, et al. Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(3), 32-35. doi: 10.11648/j.ijcts.20230903.13

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AMA Style

Papa Ousmane Ba, Myriam Bizrane, Souleymane Diatta, Jean Claude Ndiogou Dione, Momar Sokhna Diop, et al. Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma. Int J Cardiovasc Thorac Surg. 2023;9(3):32-35. doi: 10.11648/j.ijcts.20230903.13

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@article{10.11648/j.ijcts.20230903.13,
  author = {Papa Ousmane Ba and Myriam Bizrane and Souleymane Diatta and Jean Claude Ndiogou Dione and Momar Sokhna Diop and Papa Amath Diagne and Kondo Bignandi and Mory Camara and Marème Soda Mbaye and Papa Adama Dieng and Amadou Gabriel Ciss and Assane Ndiaye},
  title = {Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {9},
  number = {3},
  pages = {32-35},
  doi = {10.11648/j.ijcts.20230903.13},
  url = {https://doi.org/10.11648/j.ijcts.20230903.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230903.13},
  abstract = {Introduction: Chylous effusions are rare and their etiologies are multiple and diverse. Chylothorax is the most common; however, chylopericardium is exceptional. The aim of this work is to report the epidemiological, diagnostic and therapeutic aspects of Hodgkin lymphoma revealed by chylopericardium and bilateral chylothorax with review of the literature. Case presentation: It’s about a 34 years old man, with no particular pathological history, admitted in emergency, with a cardiac tamponade associated with a bilateral pleural effusion. The patient underwent a subxiphoid pericardiostomy and pleural drainage, removing milky pericardial (800cc) and pleural (1850cc) fluid. Fluid analysis confirmed a chylous effusion with no malignant cells. The patient was started on a low dietary fat diet which allowed a decrease in the chyle output after 10 days. A mediastinal mass biopsy was performed, through an anterior right mediastinotomy, revealing a Hodgkin lymphoma. The patient was referred to an Oncology center and underwent a full course of chemotherapy. The patient’s response to chemotherapy was favorable with a good clinical outcome and complete regression of the superior vena cava syndrome, the edema and the respiratory distress. Conclusion: It’s important to keep in mind some uncommon presentations of mediastinal tumors in general, and specifically Hodgkin Lymphoma; as well as the role of the 3 cornerstones (low-fat diet, surgery, and treatment of the underlying cause) in the management of this condition.},
 year = {2023}
}

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TY  - JOUR
T1  - Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma
AU  - Papa Ousmane Ba
AU  - Myriam Bizrane
AU  - Souleymane Diatta
AU  - Jean Claude Ndiogou Dione
AU  - Momar Sokhna Diop
AU  - Papa Amath Diagne
AU  - Kondo Bignandi
AU  - Mory Camara
AU  - Marème Soda Mbaye
AU  - Papa Adama Dieng
AU  - Amadou Gabriel Ciss
AU  - Assane Ndiaye
Y1  - 2023/06/27
PY  - 2023
N1  - https://doi.org/10.11648/j.ijcts.20230903.13
DO  - 10.11648/j.ijcts.20230903.13
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 32
EP  - 35
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20230903.13
AB  - Introduction: Chylous effusions are rare and their etiologies are multiple and diverse. Chylothorax is the most common; however, chylopericardium is exceptional. The aim of this work is to report the epidemiological, diagnostic and therapeutic aspects of Hodgkin lymphoma revealed by chylopericardium and bilateral chylothorax with review of the literature. Case presentation: It’s about a 34 years old man, with no particular pathological history, admitted in emergency, with a cardiac tamponade associated with a bilateral pleural effusion. The patient underwent a subxiphoid pericardiostomy and pleural drainage, removing milky pericardial (800cc) and pleural (1850cc) fluid. Fluid analysis confirmed a chylous effusion with no malignant cells. The patient was started on a low dietary fat diet which allowed a decrease in the chyle output after 10 days. A mediastinal mass biopsy was performed, through an anterior right mediastinotomy, revealing a Hodgkin lymphoma. The patient was referred to an Oncology center and underwent a full course of chemotherapy. The patient’s response to chemotherapy was favorable with a good clinical outcome and complete regression of the superior vena cava syndrome, the edema and the respiratory distress. Conclusion: It’s important to keep in mind some uncommon presentations of mediastinal tumors in general, and specifically Hodgkin Lymphoma; as well as the role of the 3 cornerstones (low-fat diet, surgery, and treatment of the underlying cause) in the management of this condition.
VL  - 9
IS  - 3
ER  -

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Author Information

Papa Ousmane Ba

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Myriam Bizrane

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Souleymane Diatta

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Jean Claude Ndiogou Dione

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Momar Sokhna Diop

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Papa Amath Diagne

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Kondo Bignandi

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Mory Camara

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Marème Soda Mbaye

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Papa Adama Dieng

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Amadou Gabriel Ciss

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal
Assane Ndiaye

Cardiovascular and Thoracic Surgery Department, FANN National University Hospital, Dakar, Senegal

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APA Style

Papa Ousmane Ba, Myriam Bizrane, Souleymane Diatta, Jean Claude Ndiogou Dione, Momar Sokhna Diop, et al. (2023). Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma. International Journal of Cardiovascular and Thoracic Surgery, 9(3), 32-35. https://doi.org/10.11648/j.ijcts.20230903.13

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ACS Style

Papa Ousmane Ba; Myriam Bizrane; Souleymane Diatta; Jean Claude Ndiogou Dione; Momar Sokhna Diop, et al. Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(3), 32-35. doi: 10.11648/j.ijcts.20230903.13

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AMA Style

Papa Ousmane Ba, Myriam Bizrane, Souleymane Diatta, Jean Claude Ndiogou Dione, Momar Sokhna Diop, et al. Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma. Int J Cardiovasc Thorac Surg. 2023;9(3):32-35. doi: 10.11648/j.ijcts.20230903.13

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@article{10.11648/j.ijcts.20230903.13,
  author = {Papa Ousmane Ba and Myriam Bizrane and Souleymane Diatta and Jean Claude Ndiogou Dione and Momar Sokhna Diop and Papa Amath Diagne and Kondo Bignandi and Mory Camara and Marème Soda Mbaye and Papa Adama Dieng and Amadou Gabriel Ciss and Assane Ndiaye},
  title = {Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {9},
  number = {3},
  pages = {32-35},
  doi = {10.11648/j.ijcts.20230903.13},
  url = {https://doi.org/10.11648/j.ijcts.20230903.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230903.13},
  abstract = {Introduction: Chylous effusions are rare and their etiologies are multiple and diverse. Chylothorax is the most common; however, chylopericardium is exceptional. The aim of this work is to report the epidemiological, diagnostic and therapeutic aspects of Hodgkin lymphoma revealed by chylopericardium and bilateral chylothorax with review of the literature. Case presentation: It’s about a 34 years old man, with no particular pathological history, admitted in emergency, with a cardiac tamponade associated with a bilateral pleural effusion. The patient underwent a subxiphoid pericardiostomy and pleural drainage, removing milky pericardial (800cc) and pleural (1850cc) fluid. Fluid analysis confirmed a chylous effusion with no malignant cells. The patient was started on a low dietary fat diet which allowed a decrease in the chyle output after 10 days. A mediastinal mass biopsy was performed, through an anterior right mediastinotomy, revealing a Hodgkin lymphoma. The patient was referred to an Oncology center and underwent a full course of chemotherapy. The patient’s response to chemotherapy was favorable with a good clinical outcome and complete regression of the superior vena cava syndrome, the edema and the respiratory distress. Conclusion: It’s important to keep in mind some uncommon presentations of mediastinal tumors in general, and specifically Hodgkin Lymphoma; as well as the role of the 3 cornerstones (low-fat diet, surgery, and treatment of the underlying cause) in the management of this condition.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Chylopericardium with Chylothorax as an Unusual Presentation of Hodgkin Lymphoma
AU  - Papa Ousmane Ba
AU  - Myriam Bizrane
AU  - Souleymane Diatta
AU  - Jean Claude Ndiogou Dione
AU  - Momar Sokhna Diop
AU  - Papa Amath Diagne
AU  - Kondo Bignandi
AU  - Mory Camara
AU  - Marème Soda Mbaye
AU  - Papa Adama Dieng
AU  - Amadou Gabriel Ciss
AU  - Assane Ndiaye
Y1  - 2023/06/27
PY  - 2023
N1  - https://doi.org/10.11648/j.ijcts.20230903.13
DO  - 10.11648/j.ijcts.20230903.13
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 32
EP  - 35
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20230903.13
AB  - Introduction: Chylous effusions are rare and their etiologies are multiple and diverse. Chylothorax is the most common; however, chylopericardium is exceptional. The aim of this work is to report the epidemiological, diagnostic and therapeutic aspects of Hodgkin lymphoma revealed by chylopericardium and bilateral chylothorax with review of the literature. Case presentation: It’s about a 34 years old man, with no particular pathological history, admitted in emergency, with a cardiac tamponade associated with a bilateral pleural effusion. The patient underwent a subxiphoid pericardiostomy and pleural drainage, removing milky pericardial (800cc) and pleural (1850cc) fluid. Fluid analysis confirmed a chylous effusion with no malignant cells. The patient was started on a low dietary fat diet which allowed a decrease in the chyle output after 10 days. A mediastinal mass biopsy was performed, through an anterior right mediastinotomy, revealing a Hodgkin lymphoma. The patient was referred to an Oncology center and underwent a full course of chemotherapy. The patient’s response to chemotherapy was favorable with a good clinical outcome and complete regression of the superior vena cava syndrome, the edema and the respiratory distress. Conclusion: It’s important to keep in mind some uncommon presentations of mediastinal tumors in general, and specifically Hodgkin Lymphoma; as well as the role of the 3 cornerstones (low-fat diet, surgery, and treatment of the underlying cause) in the management of this condition.
VL  - 9
IS  - 3
ER  -

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