Details

Autor(en) / Beteiligte

• Wagenpfeil, Julia
• Hoß, Katharina
• Henkel, Andreas
• Kütting, Daniel
• Luetkens, Julian Alexander
• Feldmann, Georg
• Brossart, Peter
• Attenberger, Ulrike Irmgard
• Pieper, Claus Christian

Titel

Interventional treatment of refractory non-traumatic chylous effusions in patients with lymphoproliferative disorders

Ist Teil von

• Clinical and experimental medicine, 2024-03, Vol.24 (1), p.63-63

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2024

Link zum Volltext

Quelle

SpringerLink (Online service)

Beschreibungen/Notizen

• To report results of interventional treatment of refractory non-traumatic abdomino-thoracic chylous effusions in patients with lymphoproliferative disorders. 17 patients (10 male; mean age 66.7 years) with lymphoproliferative disorders suffered from non-traumatic chylous effusions (chylothorax n = 11, chylous ascites n = 3, combined abdomino-thoracic effusion n = 3) refractory to chemotherapy and conservative therapy. All underwent x-ray lymphangiography with iodized-oil to evaluate for and at the same time treat lymphatic abnormalities (leakage, chylo-lymphatic reflux with/without obstruction of central drainage). In patients with identifiable active leakage additional lymph-vessel embolization was performed. Resolution of effusions was deemed as clinical success. Lymphangiography showed reflux in 8/17 (47%), leakage in 2/17 (11.8%), combined leakage and reflux in 3/17 (17.6%), lymphatic obstruction in 2/17 (11.8%) and normal findings in 2/17 cases (11.8%). 12/17 patients (70.6%) were treated by lymphangiography alone; 5/17 (29.4%) with leakage received additional embolization (all technically successful). Effusions resolved in 15/17 cases (88.2%); 10/12 (83.3%) resolved after lymphangiography alone and in 5/5 patients (100%) after embolization. Time-to-resolution of leakage was significantly shorter after embolization (within one day in all cases) than lymphangiography (median 9 [range 4–30] days; p  = 0.001). There was no recurrence of symptoms or post-interventional complications during follow-up (median 445 [40–1555] days). Interventional-radiological treatment of refractory, non-traumatic lymphoma-induced chylous effusions is safe and effective. Lymphangiography identifies lymphatic abnormalities in the majority of patients and leads to resolution of effusions in > 80% of cases. Active leakage is found in only a third of patients and can be managed by additional embolization.