SPONTANEOUS CHYLOTHORAX

IN NODULAR SCLEROTIC
HODGKIN’S LYMPHOMA :
A RARE CASE REPORT
E. Rakhmawati1, Widiastuti2
1Resident of Radiology Department
2Thoracic Radiology Consultant of Radiology Department

Dr. Moewardi Public Hospital, Sebelas Maret University, Surakarta

 INTRODUCTION

Chylothorax

pleural effusion type characterized by the

presence of chyle in the pleural space
with triglyceride levels >110 mg/dL.1,2

potentially life-threatening due to severe

respiratory, metabolic and immunologic
derangements.1,3
 nodular
sclerotic
RARE
Hodgkin
2013-2018 at Dr.
lymphoma Moewardi Public Hospital
Surakarta Indonesia :
1 case.7

spontaneous
chylothorax
IMPORTANT CHALLENGE
FOR RADIOLOGISTS
 OBJECTIVES

• To highlight a rare case of Chylothorax

complication in nodular sclerotic
Hodgkin lymphoma and the importance
of radiologic imaging as a diagnostic
modality.
 CASE
CXR :
Mass biopsy :
Nodular sclerotic type mediastinal mass and
Hodgkin’s lymphoma. massive bilateral pleural
effusion (fig 1,2).

Contrasted
WSD : thorax CT :
milky effusion  superior
8 days: M, 23 yo : mediastinal mass
6250 ml (left) cough,dyspnea bilateral pleural
2100 ml (right) effusion
& chest
845-1457 mg/dl discomfort. left collapsed
triglyceride levels lung
(fig 3,4). (fig 5,6,7)
 figure 1
Homogen opacity at left perihillar
suspected for mediastinal mass
figure 2
Homogen opacity at bilateral hemithorax
with right deviated trachea
demonstrating bilateral pleural effusion
6
 figure 3 figure 4
WSD at left hemithorax : Right hemithorax WSD:
Milky effussion 6250 cc Milky effussion 2100 cc
Figure 5

• Superior mediastinum
mass attach to the
vascular with bilateral
axillar, supra and infra
clavicular
lymphadenopathy

• Bilateral pleural
effussion with WSD at
left hemithorax and
callapsed lung

40
Figure 6 Figure 7
40
 DISCUSSION

thorax
CXR : CT location,
mediastinal
mass and source of
pleural chylous
effusion leakage,
(little evaluates
diagnostic post
value).3,4 WSD3,5,6
 CONCLUSION
• Spontaneous Chylothorax complication
in nodular sclerotic Hodgkin lymphoma
is rare and life-threatening event if it is
not properly treated.

• Radiologic imaging plays an important

role in establishing the diagnosis
 REFERENCES
1. Rajdev K, Avula A, Sharra D. A Case of Transudative Chylothorax:
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2. Bencher B, Murthy V, Chamberlin R S. The Changing Management
of Chylothorax in The Modern Era. European Journal of Cardio
Thoracic Surgery. 2015; 1-7
3. Ansell S M. Hodgkin Lymphoma: Diagnosis and Treatment. Mayo
Clinic. 2015; 90 (11): 1574-1583
4. Lee S Joeng, Rho J Young. Anterior Mediastinal Hodgkin
Lymphoma Presenting as An Extremely Hypervascular Tumor on
Computed Tomography. Medicine Journal; 97:19
5. Kim P, Tsavo J, Shin J. Lymphatic Interventions for Chylothorax: A
Systematic Review and Meta-Analysis.Journal of Vascular and
Interventional Radiology
6. Shahrzad M, Lee T, Silva M. Anterior Mediastinal Masses.American
Journal of Roentgenology. 2014; 203: W128-W138
7. Patient Report of RS DR. Moewadi based on ICD 10 RSDM