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Management of lymphoma-associated chylothorax by interventional radiology and chemotherapy: a report of five cases

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Abstract

Chylous effusion is associated with lymphatic obstruction or leakage in mediastinal or abdominal lymph nodes, and is a rare but troublesome complication in patients with malignant lymphomas. Although there is no standard of care, it is often treated with simultaneous chemotherapeutic and non-chemotherapeutic interventions. Here, we describe the cases of five patients with lymphoma-associated chylothorax with the aim of clarifying an effective treatment strategy. All patients achieved a partial response or better for lymphoma. All patients underwent interventional radiology (IVR) procedures, including lymphangiography (LAG) and thoracic duct embolization (TDE). Complete resolution of chylothorax was eventually achieved by IVR procedures or pleurodesis in all patients. No patients experienced serious adverse events related to LAG/TDE. Treatment of chylous effusion required months for most patients (range: 0.2–4.8 months). Our data suggest that a combination of chemotherapy and LAG/TDE is effective for refractory lymphoma-related chylous effusion.

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Acknowledgements

We thank Editage (www.editage.jp) for the English language editing. No funding was received for this study. We thank Dr. Ikuo Yamazaki (Department of Radiology, Kameda Medical Center, Japan) for the highly skilled IVR procedures and Dr. Hiroshi Sugimura for surgical procedures.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, 929 Higashi-chou, Kamogawa, Chiba, 296-8602, Japan

    Ami Fukumoto, Toshiki Terao, Ayumi Kuzume, Rikako Tabata, Takafumi Tsushima, Daisuke Miura, Daisuke Ikeda, Yuya Kamura, Kentaro Narita, Masami Takeuchi & Kosei Matsue

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  1. Ami Fukumoto
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  2. Toshiki Terao
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  3. Ayumi Kuzume
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  5. Takafumi Tsushima
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Contributions

AF and TTe wrote and edited the manuscript, performed the patient care, and reviewed the literature. AF wrote the first manuscript. AK, RT, TTs, DM, DI, YK, KN, and MT provided the patient care. KM wrote and edited the manuscript. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Kosei Matsue.

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Fukumoto, A., Terao, T., Kuzume, A. et al. Management of lymphoma-associated chylothorax by interventional radiology and chemotherapy: a report of five cases. Int J Hematol 116, 579–585 (2022). https://doi.org/10.1007/s12185-022-03397-7

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  • DOI: https://doi.org/10.1007/s12185-022-03397-7

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