Inflammatory sternal metastasis heralding lung cancer: two cases.

Bone pain due to bone metastases is a frequent presenting symptom of lung cancer. However, sternal metastases are unusual. We report two patients with inflammatory sternal metastases mimicking osteitis and indicating lung cancer. Chest computed tomography scan showed lytic lesion of the sternal manubrium invading anterior soft tissue. Diagnosis relied on histological examination of sternal biopsy and negative bacteriologic cultures. Local radiotherapy resulted in resolution of local signs.

[Chylous ascitis revealing a non-Hodgkin lymphoma]. / Ascite chyleuse révélatrice d'un lymphome non hodgkinien.

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.