A rare coincidence of a chylothorax and a hydrothorax caused by gastric adenocarcinoma – a case report

Czech version

Authors: Nela Šťastná ^1,2; doc. MUDr. Kristián Brat, Ph.D. ^1,2
Authors‘ workplace: Klinika nemocí plicních a TBC, Fakultní nemocnice Brno ¹; Lékařská fakulta Masarykovy Univerzity, Brno ²
Published in: Vnitř Lék 2020; 66(7): 43-45
Category: Case Report

Overview

We present a case report of a 74-years old patient with a finding of bilateral pleural effusion due to a different fluid composition caused by gastric adenocarcinoma. The finding of a bilateral effusion, where the exudate fluid is of a different chemical composition, is a rare phenomenon. While the right-sided exudate had the characteristics of hydrothorax, the left-sided exudate had those of chylothorax. The initial suspicion of a lung tumor was not confirmed, and further examination surprisingly revealed gastric adenocarcinoma. The patient did not benefit from targeted oncological treatment for a long time and the chemotherapy was terminated after 3 cycles. The cause of right-sided hydrothorax is therefore attributed to hypalbuminemia and secondary pneumonia, left-sided chylothorax was a primo-manifestation of gastric adenocarcinoma. There is only a small number of similar case reports of patients with gastric tumor and chylothorax in the literature. While the recorded cases were mostly Asian ethnic patients, the course of their illness – including survival – was almost strikingly similar (and unfavorable).

Keywords:

gastric adenocarcinoma – chylothorax – bilateral pleural effusion

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