[Chylous ascitis revealing a non-Hodgkin lymphoma].
BACKGROUND
Chylous ascitis is a rare form of ascitis, characterised by a milky, triglyceride-rich, liquid. It is due to an interruption in the lymphatic system due either to an obstruction or to a post-traumatic wound. We report a case of revealing a non-Hodgkin lymphoma.


METHODS
A 71 Year-old man consulted for abdominal distension attributed to a chylous ascitis. Peripheral adenopathies were palpable. The abdominal scan revealed voluminous lumbar-aortal adenopathies. The diagnosis of grade IV (Ann Arbor classification) centro-follicular non-Hodgkin lymphoma was retained. The ascitis disappeared following chemotherapy.


CONCLUSIONS
Chylous ascitis is an uncommon complication of lymphomas, although representing the main cause in adults in developed countries. The underlying mechanism is an obstruction to sub-diaphragmatic draining lymphatic due to lymphomatous infiltration. Hyperalimentation, a low, dietary restriction of long-chain triglycerides or peritoneovenous shuntings are ineffective.


CONCLUSIONS
Chylous ascitis is a rare complication of lymphomas, secondary to the obstruction of the abdominal draining lymphatics. Treatment is the same as that of a hematologic malignancy.
Bachmeyer
Claude
C
Département de médecine interne, Centre hospitalier, Laënnec. claude.bachmeyer@ch-creil.fr
Henni
Mehdi Alexandre
MA
Blanc
Anne-Sophie
AS
Langman
Benjamin
B
Kazerouni
Firouze
F
Cadranel
Jean-François
JF
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002915:Chylous Ascites / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008224:Lymphoma, Follicular / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D011860:Radiography, Abdominal; D012074:Remission Induction; D014057:Tomography, X-Ray Computed