A Case of Adult T-Cell Leukemia/Lymphoma Complicated with Bilateral Chylothorax

Author:

Kako Satoko12,Joshita Satoru13ORCID,Matsuo Akemi2,Kawaguchi Kenji4,Umemura Takeji13,Tanaka Eiji1

Affiliation:

1. Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan

2. Department of Respiratory Medicine, Shinonoi General Hospital, Nagano, Japan

3. Research Center for Next Generation Medicine, Shinshu University, Matsumoto, Japan

4. Department of Diagnostic Pathology, Shinonoi General Hospital, Nagano, Japan

Abstract

We present the case of a 74-year-old Japanese woman who presented with dyspnea, a palpable right breast mass, and swollen right axillary lymph node. Imaging studies revealed bilateral pleural effusion and systemic lymph adenopathy and pleural fluid study showed high levels of triglycerides. A right inguinal lymph node biopsy disclosed malignant lymphoma cells that were human T-cell leukemia virus type 1 (HTLV-1) provirus DNA-positive, a condition endemic to patient’s birthplace, by the Southern blot hybridization method. She was diagnosed as having adult T-cell leukemia/lymphoma (ATL) with chylothorax. After commencing chemotherapy for ATL, her chylothorax disappeared and swollen lymph nodes reduced remarkably, indicating an association between the chylothorax and ATL. Bilateral chylothorax is a relatively rare condition associated with such nontraumatic causes as ATL. Clinicians should therefore bear chylothorax in mind when encountering patients with pleural effusion. A detailed medical history can also enable prompt diagnosis and appropriate treatment.

Publisher

Hindawi Limited

Subject

Oncology

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