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[Chylous ascitis revealing a non-Hodgkin lymphoma]
Claude Bachmeyer1, Mehdi Alexandre Henni, Anne-Sophie Blanc
1Département de médecine interne, Centre hospitalier, Laënnec. claude.bachmeyer@ch-creil.fr
Introduction:
Chylous ascitis is a rare form of ascitis, characterised by a milky, triglyceride-rich, liquid. It is due to an interruption in the lymphatic system due either to an obstruction or to a post-traumatic wound. We report a case of revealing a non-Hodgkin lymphoma.
Observation:
A 71 Year-old man consulted for abdominal distension attributed to a chylous ascitis. Peripheral adenopathies were palpable. The abdominal scan revealed voluminous lumbar-aortal adenopathies. The diagnosis of grade IV (Ann Arbor classification) centro-follicular non-Hodgkin lymphoma was retained. The ascitis disappeared following chemotherapy.
Comments:
Chylous ascitis is an uncommon complication of lymphomas, although representing the main cause in adults in developed countries. The underlying mechanism is an obstruction to sub-diaphragmatic draining lymphatic due to lymphomatous infiltration. Hyperalimentation, a low, dietary restriction of long-chain triglycerides or peritoneovenous shuntings are ineffective.
Conclusion:
Chylous ascitis is a rare complication of lymphomas, secondary to the obstruction of the abdominal draining lymphatics. Treatment is the same as that of a hematologic malignancy.