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Case Report
Successful management of primary intestinal diffuse large B-cell lymphoma complicated with chylothorax
1 MD, Division of Hematology and Medical-Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
2 MD, PhD, Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
Address correspondence to:
Mardiah Suci Hardianti
MD, PhD, Division of Hematology and Medical-Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281,
Indonesia
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Article ID: 101292Z01DM2022
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How to cite this article
Meliala DP, Handaya AY, Bagaskoro RM, Dinantia N, Hardianti MS. Successful management of primary intestinal diffuse large B-cell lymphoma complicated with chylothorax. Int J Case Rep Images 2022;13:101292Z01DM2022.ABSTRACT
Introduction: Primary intestinal non-Hodgkin’s lymphoma is a part of extranodal non-Hodgkin’s lymphoma which is rare in incidence, moreover when complicated with chylothorax.
Case Report: A 26-year-old female patient was referred to our hospital presenting a distended abdomen, dyspnea, and sepsis due to infected surgical wound from a laparotomy and hemi-colectomy with ileostomy done 11 days before in other hospital. Pathology result was an intestinal activated B-cell non-Hodgkin lymphoma with positive CD20 and MUM1 immunostaining. A massive milky pleural effusion with a high level of triglycerides indicating a chylothorax was managed by insertion of water seal drainage. An R-CHOP regimen was commenced after stabilization of critical condition, and the chylothorax improved after two cycles of chemotherapy. The patient completed eight cycles of R-CHOP and achieved complete remission followed by a surgical re-anastomosis. She remained in complete remission with fully active life for almost four years until this report was submitted.
Conclusion: This case emphasized the importance of awareness due to the non-specific symptoms of an intestinal lymphoma. The prompt evacuation of co-occurring chylothorax is another important management to highlight. Optimum primary surgery followed by R-CHOP chemotherapy has led to successful outcome as remarked by prolonged disease free survival in this case.
Keywords: Chylothorax, DLBCL, Intestinal lymphoma, Lymphoma
SUPPORTING INFORMATION
Author Contributions
Dian Pratiwi Meliala - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Adeodatus Yuda Handaya - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Radhea Miraz Bagaskoro - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nugira Dinantia - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mardiah Suci Hardianti - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Dian Pratiwi Meliala et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
