Devaraj Uma, Ramachandran Priya, Correa Marjorie, D'souza George A
Department of Chest Medicine, St. John's Medical College and Hospital, Bangalore, Karnataka, India.
Department of Pathology, St. John's Medical College and Hospital, Bangalore, Karnataka, India.
Lung India. 2014 Jan;31(1):47-52. doi: 10.4103/0970-2113.125906.
Chylothorax is a rare complication of gastric adenocarcinoma and data on its identification, prevalence and outcomes are scant.
To enable identification of gastric carcinoma as a cause of chylothorax.
A case report and a systematic review were conducted of all reported cases of gastric adenocarcinoma with chylothorax as the presenting complaint in the English literature.
Chylothorax is a rare presenting complaint of gastric adenocarcinoma. There are only 18 case reports in the world literature, of which six are in English. Chylothorax occurred variably in gastric adenocarcinoma, either as a presenting feature or as a complication of therapy. Here, we analyze the index case and six patients in whom gastric carcinoma presented with chylothorax as the initial symptom. Respiratory features of cough and dyspnea preempted any abdominal complaint. Bilateral chylothorax (66%) with associated chylous ascites (50%) was common. Four of the six patients had skin lymphedema also as a prominent feature. The chylothoraces have been treated by therapeutic pleurocentesis, intercoastal tube drainage and restriction of oral intake. Gastric adenocarcinoma was associated with high mortality (50%) and morbidity.
Chylothorax can be the presenting feature of gastric adenocarcinoma. A thorough search for this life-threatening disease should be done before labeling the chylothorax as idiopathic.
乳糜胸是胃腺癌的一种罕见并发症，关于其识别、患病率及预后的数据较少。
明确胃癌为乳糜胸的病因。
对英文文献中所有以乳糜胸为首发症状的胃腺癌报道病例进行病例报告及系统综述。
乳糜胸是胃腺癌罕见的首发症状。世界文献中仅有18例病例报告，其中6例为英文报道。乳糜胸在胃腺癌中表现各异，可为首发特征或治疗并发症。在此，我们分析了索引病例及6例以乳糜胸为初始症状的胃癌患者。咳嗽和呼吸困难等呼吸症状先于任何腹部症状出现。双侧乳糜胸（66%）伴乳糜性腹水（50%）较为常见。6例患者中有4例还以皮肤淋巴水肿为突出特征。乳糜胸采用治疗性胸腔穿刺、肋间置管引流及限制口服摄入进行治疗。胃腺癌与高死亡率（50%）及高发病率相关。
乳糜胸可为胃腺癌的首发特征。在将乳糜胸标记为特发性之前，应彻底排查这种危及生命的疾病。
