Wu Jie, Lv Liang, Zhou Kunyan, Huo Jirong
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China.
Department of Gastroduodenal Surgery, Hunan Cancer Hospital of Xiangya Medical School, Central South University, Changsha, Hunan 410013, P.R. China.
Oncol Lett. 2016 Apr;11(4):2835-2838. doi: 10.3892/ol.2016.4285. Epub 2016 Feb 29.
Chylothorax is the accumulation of lymph fluid in the pleura. Gastric carcinoma with chylothorax and lymphedema as the initial manifestations has rarely been reported, with only 14 cases reported to date. The mechanisms of gastric carcinoma generating chylothorax have not yet been determined. The current study reports the case of a 63-year-old woman presenting with chylothorax and lower extremity lymphedema, and reviews the existing literature. A chest radiograph performed on the present patient revealed large pleural effusion and chylothorax was diagnosed. Upper gastrointestinal endoscopy identified an irregular apophysis lesion and a biopsy confirmed poorly differentiated gastric adenocarcinoma. The patient was discharged at her request, and subsequently succumbed to the disease 4.5 months later. Based on the findings of the present study, as well as those of the literature, we proposed a novel form of gastric carcinoma infiltrating the body. Chylothorax and lymphedema may be a consequence of gastric carcinoma cells infiltrating the lymphatic circulatory system; therefore, the differential diagnosis of chylothorax and lymphedema of unknown cause should consider gastric carcinoma, regardless of gastrointestinal symptoms.
乳糜胸是指胸膜腔内淋巴液的积聚。以乳糜胸和淋巴水肿为首发表现的胃癌鲜有报道，迄今为止仅报道了14例。胃癌导致乳糜胸的机制尚未明确。本研究报告了1例63岁女性患者，以乳糜胸和下肢淋巴水肿为表现，并回顾了现有文献。对该患者进行的胸部X线检查显示有大量胸腔积液，诊断为乳糜胸。上消化道内镜检查发现一个不规则的隆起病变，活检证实为低分化胃腺癌。患者要求出院，随后在4.5个月后死于该疾病。基于本研究以及文献的发现，我们提出了一种浸润身体的新型胃癌形式。乳糜胸和淋巴水肿可能是胃癌细胞浸润淋巴循环系统的结果；因此，对于原因不明的乳糜胸和淋巴水肿进行鉴别诊断时，无论有无胃肠道症状，均应考虑胃癌。
