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[Generalized lymphangiomatosis with chylopericardium]

A Manetti1, L De Simone, I Pollini

  • 1Unità Operativa di Cardiologia, Ospedale A. Meyer, Firenze, Italia.

Insights

This case report details a child with lymphangiomatosis and chylopericardium, highlighting diagnostic methods and treatment challenges. The condition ultimately proved fatal due to widespread disease progression.

Area of Science:

  • Pediatric Cardiology
  • Medical Genetics
  • Thoracic Surgery

Background:

  • Lymphangiomatosis is a rare congenital disorder characterized by abnormal proliferation of lymphatic vessels.
  • Chylopericardium, the accumulation of lymphatic fluid in the pericardial space, can be a life-threatening complication.

Observation:

  • A case of a child diagnosed with lymphangiomatosis and chylopericardium at 11 months is presented.
  • Ascendant lymphography revealed thoracic duct agenesis, a significant finding in lymphatic malformations.
  • The patient underwent surgical intervention (pleuropericardial window) and dietary management (low-fat medium-chain triglyceride diet).

Findings:

  • Initial treatment provided temporary clinical improvement, but the underlying lymphangiomatosis continued to progress.
  • Extensive lymphangiomatosis affecting the abdomen, lungs, and bones was observed.
  • The patient succumbed to the disease at 13 years of age.

Implications:

  • This case underscores the challenges in managing pediatric lymphangiomatosis with chylopericardium.
  • Early diagnosis and multidisciplinary management are crucial for improving outcomes in lymphatic anomalies.
  • Further research into novel therapeutic strategies for extensive lymphangiomatosis is warranted.

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