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Chylothorax in Uncommon Contexts: Pulmonary Tuberculosis and Mantle Cell Lymphoma
Guru Prasad T J1, Athish Kannan Karur1, Spurthy Padmanabha1
1Department of TB and Chest Disease Sri Devaraj Urs Academy of Higher Education and Research Kolar Karnataka India.
Respirology Case Reports
|July 11, 2025
Summary
Chylothorax, a rare condition of lymphatic fluid in the pleural space, can stem from tuberculosis or mantle cell lymphoma. Prompt diagnosis and tailored treatment are crucial for managing this condition.
Area of Science:
- Pulmonology
- Infectious Diseases
- Oncology
Background:
- Chylothorax involves chyle accumulation in the pleural space, a rare but significant condition.
- Causes include trauma, malignancy (lymphoma), and tuberculosis (TB).
- Iatrogenic trauma is a common cause, but uncommon etiologies require consideration.
Purpose of the Study:
- To highlight uncommon causes of chylothorax.
- To present cases of chylothorax due to tuberculosis and mantle cell lymphoma.
- To emphasize the need for etiology-specific treatment.
Main Methods:
- Case series analysis of three patients with chylothorax.
- Diagnostic methods included pleural fluid analysis (triglycerides), bronchoalveolar lavage, imaging, and biopsy.
- Treatment involved anti-tubercular therapy, dietary modification, and chemotherapy.
Main Results:
- Two patients with chylothorax were diagnosed with tuberculosis (TB) and responded to anti-TB therapy and diet.
- One patient with a history of lymphoma developed chylothorax due to mantle cell lymphoma (MCL) and responded to chemotherapy.
- Pleural effusions were characterized by high triglyceride levels (>180 mg/dL).
Conclusions:
- Chylothorax evaluation must include uncommon causes like TB and lymphoma.
- Treatment strategies should be tailored to the specific underlying etiology.
- Early diagnosis and appropriate management improve patient outcomes.
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