Refractory Chylothorax and Lymphedema Caused by Advanced Gastric Cancer

Intern Med. 2019 Nov 1;58(21):3143-3148. doi: 10.2169/internalmedicine.2351-18. Epub 2019 Jul 10.

Abstract

Chylothorax is the accumulation of lipid pleural effusion. Few reports have described chylothorax caused by gastric cancer. A 45-year-old woman presented with progressive lymphedema and bilateral chylothorax. Although repetitive thoracentesis was performed to relieve her dyspnea, swelling of her axillary lymph nodes became significant. Positron emission tomography/computed tomography demonstrated the accumulation of 18F-fluorodeoxyglucose in these nodes, and a lymph node biopsy showed signet ring cell carcinoma. The primary site was a 0-IIc type lesion in the gastric body that was only detected by upper gastrointestinal endoscopy. The patient was diagnosed with advanced gastric cancer 3.5 months after presentation for chylothorax.

Keywords: chylothorax; gastric cancer; lymphedema; signet ring cell carcinoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Carcinoma, Signet Ring Cell / complications*
  • Carcinoma, Signet Ring Cell / diagnostic imaging
  • Carcinoma, Signet Ring Cell / pathology
  • Chylothorax / etiology*
  • Chylothorax / therapy
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Lymphedema / etiology
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Radiography, Thoracic
  • Stomach Neoplasms / complications*
  • Stomach Neoplasms / diagnostic imaging
  • Stomach Neoplasms / pathology
  • Thoracentesis