A case of chylothorax due to primary renal lymphoma

Abstract

Chylothorax is a type of pleural effusion which develops by collection of lymphatic fluid in the pleural cavity after disruption or blockage of the thoracic duct.

The posterior-anterior lung graphy revealed a left pleural effusion during routine controls of an asymptomatic 79 year-old male patient. Pleural fluid with a chylous appearance drained by thoracentesis had a triglyceride level of 409 mg/dL. As chylothorax was thought as diagnosis, thoracoabdominal computed tomography revealed a left renal mass and left pleural effusion. There was a mass lesion taking origin from the superior pole of the left kidney with multiple periaortic and perirenal lymphadenopathies in magnetic resonance imaging of the abdomen, which was interpreted as lymphoma. The tru-cut biopsy from renal lesion revealed as diffuse large B-cell non-Hodgkin lymphoma (NHL).

Non-traumatic chylothorax is most commonly due to malignancy. Lymphoma is the most common cause of chylothorax with approximately 75%. Primary renal lymphoma, a type of NHL, has not ever found as a cause of chylothorax in our literature investigation. In this paper, we report this rarely seen case.