Author/Authors :
Tanaka, Eiji Department of Medicine - Division of Gastroenterology and Hepatology - Shinshu University School of Medicine - Matsumoto, Japan , Kako, Satoko Department of Medicine - Division of Gastroenterology and Hepatology - Shinshu University School of Medicine - Matsumoto, Japan , Joshita, Satoru Department of Medicine - Division of Gastroenterology and Hepatology - Shinshu University School of Medicine - Matsumoto, Japan , Matsuo, Akemi Department of Respiratory Medicine - Shinonoi General Hospital - Nagano, Japan , Kawaguchi, Kenji Department of Diagnostic Pathology - Shinonoi General Hospital - Nagano, Japan , Umemura, Takeji Research Center for Next Generation Medicine - Shinshu University - Matsumoto, Japan
Abstract :
We present the case of a 74-year-old Japanese woman who presented with dyspnea, a palpable right breast mass, and swollen rightaxillary lymph node. Imaging studies revealed bilateral pleural effusion and systemic lymph adenopathy and pleuralfluid studyshowed high levels of triglycerides. A right inguinal lymph node biopsy disclosed malignant lymphoma cells that were humanT-cell leukemia virus type 1 (HTLV-1) provirus DNA-positive, a condition endemic to patient’s birthplace, by the Southern blothybridization method. She was diagnosed as having adult T-cell leukemia/lymphoma (ATL) with chylothorax. Aftercommencing chemotherapy for ATL, her chylothorax disappeared and swollen lymph nodes reduced remarkably, indicating anassociation between the chylothorax and ATL. Bilateral chylothorax is a relatively rare condition associated with suchnontraumatic causes as ATL. Clinicians should therefore bear chylothorax in mind when encountering patients with pleuraleffusion. A detailed medical history can also enable prompt diagnosis and appropriate treatment.
