RESUMO
INTRODUCTION: 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. OBSERVATION: 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. COMMENTS: 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. CONCLUSION: 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.
