Lymphatic intervention in the management of chylothorax in FDG-PET/CT negative Hodgkin lymphoma

Chylothorax is an infrequent nontraumatic cause of Hodgkin's lymphoma, and chylous pericardial effusion is a rare association. Only a few cases of unilateral chylothorax with chylous pericardial effusion in Positron emission tomography (PET)-negative Hodgkin's lymphoma are documented worldwide. Hence, we report a case of a 21-year-old female with Hodgkin's lymphoma on chemotherapy who presented with breathlessness and facial puffiness. MR lymphangiography revealed obstruction of the terminal part of the thoracic duct with chyloreflux in the left infraclavicular region. Management included both traditional medical and interventional approaches to disrupt the lymphatic network. Intranodal lymphangiography with lipiodol confirmed the MRI findings. Drain output is reduced as lymphangiography can be therapeutic.