Chylothorax in paediatrics: A diagnostic challenge - A case report

Abstract

Chylothorax is a rare but potentially life-threatening cause of pleural effusion in paediatric patients with a broad differential diagnosis. We present the case of an adolescent with a medical history of treated latent tuberculosis, presenting with subacute respiratory symptoms set against a background of a two-month history of constitutional symptoms and generalized lymphadenopathy. During hospitalization, the patient developed a right-sided pleural effusion. A thorough investigation documented stage IVB nodular sclerosis classical Hodgkin lymphoma complicated by chylothorax. This case underscores the importance of considering a broad spectrum of etiologies in the differential diagnosis of paediatric chylothorax. Although rare, its occurrence, particularly in the absence of trauma, warrants thorough investigation to exclude lymphoma, the most common malignancy linked to this condition. Additionally, the article provides a concise review of the diagnosis and therapeutic approach to chylothorax, and highlights the challenges this condition poses to the management of cancer patients.