Keywords
non-Hodgkin's lymphoma
child
Niger
How to Cite
Abstract
Introduction :
Chylous effusion in serous membranes is a rare syndrome in medical practice. It can be indicative of various pathologies, including tumors. The objective of this study was to report one (1) case of chylous effusion revealing a non-Hodgkin's malignant lymphoma (NHL) in a 5-year-old child at the National Hospital Amirou Boubacar Diallo, Niamey.
Case report :
This involved a 5-year-old male child, initials HH, referred from the Integrated Health Center of Kouré for dyspnea and abdominal distension evolving over about 3 months in a febrile context, with no known pathological history. There was no notion of tuberculous contact upon questioning. On admission, he presented with a syndrome of chylous pleural and peritoneal effusion. Latero-cervical adenopathies and an altered general condition were noted. The triglyceride level was high in the blood. The hypothesis of a lymphoma was put forward and a lymph node puncture performed supported this diagnosis. An extension workup was initiated when the child's death occurred in the context of septicemia.
Conclusion :
The clinical presentation of lymphomas is polymorphic; systematically considering it in the presence of an association of a chylous edema-ascites syndrome and a tumoral syndrome is life-saving, as late diagnosis worsens the prognosis
References
1. Thouil A. et al. Les épanchement chyleux (à propos de 5 cas). Rev Mal Respir. janv 2019;36:A157.
2. Wagenpfeil J, Hoß K, Henkel A, Kütting D, Luetkens JA, Feldmann G, et al. Interventional treatment of refractory nontraumatic chylous effusions in patients with lymphoproliferative disorders. Clin Exp Med. 30 mars 2024;24(1):63.
3. Fukumoto A, Terao T, Kuzume A, Tabata R, Tsushima T, Miura D, et al. Management of lymphoma-associated chylothorax by interventional radiology and chemotherapy: a report of five cases. Int J Hematol. 1 oct 2022;116(4):579-85.
4. Schild HH, Strassburg CP, Welz A, Kalff J. Treatment Options in Patients With Chylothorax. Dtsch Ärztebl Int. 29 nov 2013;110(819):26.
5. 5Drouet F, Cahu X, Pointreau Y, Denis F, Mahé MA. Lymphomes malins non hodgkiniens. Cancer/Radiothérapie. nov 2010;14:S210-29.
6. Streitparth F, Theurich S, Streitparth T, Öcal O, dos Santos DC, Flatz W. Treatment of Refractory High-Flow Chylothorax in HighGrade B-Cell Lymphoma by Intratumoral Lymphatic Embolization. Cardiovasc Intervent Radiol. 2021;44(12):2002-4.
7. Salamatou Mamoudou Garba, Harouna Mahamadou Zaki, Amine Arfaoui, Hinde Hami, Abdelmadjid Soulaymani, Hassan Nouhou, et al. Epidémiologie des cancers au Niger, 1992 à 2009. 2013;100(2):127-33.
8. Sugeeth MT, Narayanan G, V Soman L. Chylous pleural effusion: A rare presentation of Non-Hodgkin-Lymphoma. Iran J Blood Cancer. 2018;10(4):130-2.
9. Das DK. Serous effusions in malignant lymphomas: A review. Diagn Cytopathol. mai 2006;34(5):335-47.
10. Etonyeaku AC, Akinsanya OO, Ariyibi O, Aiyeyemi AJ. Chylothorax from Bilateral Primary Burkitt’s Lymphoma of the Ovaries: A Case Report. Case Rep Obstet Gynecol. 2012;2012:1-3.
11. Jagosky M, Taylor B, Taylor SP. A Case of Chyloperitoneum Secondary to Follicular Lymphoma and a Review of Prognostic Implications. Case Rep Hematol. 2016;2016:4625819.
12. Alattal SAD, Alattal S, Choi J, Khaleeq G, Ghnaima H, Nader G, et al. A Case of Bilateral Pleural Effusion; Chylous Pleural Effusion on the Left Side and Malignant Pleural Effusion on the Rt Side, American Thoracic Society; 2024. p. A2684-A2684.
13. Sequeira M, Nogueira F, Pestana Santos C, Judas T, Delerue F. A Rare Case of a Chylous Pleural Effusion as the Initial Manifestation of Synchronous Tumors. Cureus. oct 2023;15(10):e46903.
14. Zhang Y, Lin Z, Zhang F, Chen X, Yang Y, Fu X, et al. Rapid response in relapsed follicular lymphoma with massive chylous ascites to anti-CD19 CAR T therapy using Piggy Bac: A case report. Front Immunol. 2022;13:1007210.
15. Trivedi M, Chandar R, Nair M, Jacob PM, Thankamony P. Primary Mediastinal Large B-Cell Lymphoma in a Child Presenting With Superior Mediastinal Syndrome and Chylous Pleural and Pericardial Effusion. J Pediatr Hematol Oncol. juill 2020;42(5):e369-72.
16. Alam MR, Hasan MN, Rahim MA, Ahmed QMU, Islam MS, Rahman MA, et al. Chylous effusions (pleural effusion and ascites) due to non-Hodgkin’s lymphoma a case report. Bangladesh Med J. 2018;47(2):38-40.
17. Jiang Y, Xie W, Hu K, Sun J, Zhu X, Huang H. An aggressive form of non-Hodgkin’s lymphoma with pleural and abdominal chylous effusions: A case report and review of the literature. Oncol Lett. oct 2013;6(4):1120-2.
18. Hufford S, Hu E. Lymphoma and chylous ascites. West J Med. 1988;148(5):581.
19. Weick JK, Kiely JM, Harrison EG, Carr DT, Scanlon PW. Pleural effusion in lymphoma. Cancer. avr 1973;31(4):848-53.
20. Bruneau R, Rubin P. The Management of Pleural Effusions and Chylothorax in Lymphoma. Radiology. déc 1965;85(6):1085-92.
21. Avon JT, Gerrard AJ, Patel BB. Chylous Ascites Developing Into Bilateral Chylothorax in High-Grade Lymphoma: A Case Report. Cureus. 2023;15(4):e37344. doi:10.7759/cureus.37344.
22. Gabali A. Serous fluids and hematolymphoid disorders. Cytojournal, 19 mars 2022; p19.
23. Chylothorax secondaire à une hémopathie maligne : à propos de 5 cas. 21e Congrès de pneumologie de langue française — Marseille. 2017.
24. Hmamouche L et al. Chylothorax postopératoire. Maroc Méd. mars 2006;28(1):36-8.
25. Chemaou A, Ayachi M, Ailal F, Najib J. Chylothorax idiopathique chez un nourrisson. Prise en charge et évolution. Arch Pédiatrie. juill 2012;19(7):711-3.
26. De Sousa P, Viart L, Petit J, Saint F. Ascite chyleuse post-surrénalectomie laparoscopique transpéritonéale : distribution anatomique des lymphonœuds et prise en charge thérapeutique. Prog En Urol. mai 2010;20(5):385-8.
27. F. Hmami, A. Oulmaati, C. Bouchikhi, A. Banani, A. Bouharrou et al. Chylothorax congénital : une réponse rapide et totale à la polyvidone iodée. 3719. Elsevier Masson. 2014;1-4.
28. Staats BA, Ellefson RD, Budahn LL, Dines DE, Prakash UB, Offord K. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc. nov 1980;55(11):700-4.
29. Benhamou R, Simon I, Nortier J, Baudoux T, Catalano C. Chylothorax en hémodialyse : pensez à la lercanidipine ! Néphrologie Thérapeutique. sept 2018;14(5):306-7. 1128B
Metrics
Downloads
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 I Abass Albana, O Adamou Chaibou, A Ayouba Ousseini, A Samaila, M Yahaya, M Garba, O Abdoulaye Soumana, H Amadou Adamou, A Yonli, S Alido