Chylothorax and chylopericardium, as a complication of acute lymphoblastic leukemia in a child: Successful result after pleurectomy and pericardiostomy

Abstract

A 12-year-old-girl, previously diagnosed ALL-L1 was admitted to our emergency department with the diag¬nosis of chylothorax and chylopericardium. Thoracentesis retrieved chylous fluid milky in appearance, which was positive for atypical lymphocytes; ALL relapse was diagnosed and BFM 95 protocol was started. Echocardiography showed pericardial effusion and tube pericardiostomy was carried out. The patient had drainage of the pleural effusion but chyle leak did not cease after a period of 3 weeks. A CAT scan showed left superior mediastinal mass causing narrowing of the trachea. Then thoracotomy and parietal pleurectomy was performed. The postoperative course was uneventful, and the patient was discharged.

Özet

ALL-L1 tanısıyla takip edilmekte olan 12 yaşındaki kız hasta, şilotoraks ve şiloperikardium tablosu ile acil birimimize başvurdu. Yapılan toraks drenajı neticesinde süt kıvamında şilöz sıvı aspirç edildi ve atipik lenfositlerin varlığı saptandı. Hasta ALL relapsı olarak değerlendirildi ve BFM 95 protokolü başlandı. Ekokardiografide perikardial effüzyonu saptanan olguya tüp perikardiostomi uygulandı. Hastaya uygulanan tüp torakostomiden 3 hafta süreyle şilöz drenaj devam etti. CT'de trakeayı daraltan sol superior mediastinal kitle saptandı ve hastaya torakotomi ve parietal pleurektomi uygulandı. Postoperatif seyri sorunsuz seyreden hasta taburcu edildi.

Keywords: Şilotoraks,Perikardiyal efüzyon,Çocuk,Torakostomi,Torakotomi,Lösemi