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Successful Treatment of Bilateral Refractory Chylous Effusion of Non-Hodgkin Lymphoma Patient with Octreotide


Chylothorax is leakage of the thoracic duct content into the pleural cavity due to congenital defects, trauma, tumor infiltration, postoperative cardiac or esophageal procedures. Traditional approaches to chylothorax include thoracentesis and pleurodesis, which are invasive and often result in significant patient morbidity and mortality. In a patient who is a nonsurgical candidate, octreotide presents a better alternative. Octreotide, an analogue of somatostatin, was first used more than a decade ago to treat chylous effusions. Octreotide’s treatment for lymphoma-induced chylothorax has rarely been reported. Through our literature search, we found that our case is among the few bilateral lymphoma-induced chylous effusion cases treated by octreotide in the world. Our patient was treated with octreotide and combined with medium chain triglyceride (MCT) with strict low fat/low calorie diet. After ten days of treatment, there was a significant reduction of chylous effusion. Patient was subsequently discharged and recovered significantly without recurrence for the past eight months.