# Chylothorax as the Initial Manifestation of Small Cell Lung Carcinoma

## TL;DR

A 63-year-old smoker was diagnosed with lung cancer after presenting with chylothorax, highlighting the importance of thorough investigation for rare cancer symptoms.

## Contribution

This case highlights chylothorax as a rare initial sign of small cell lung carcinoma and emphasizes the need for comprehensive diagnostic approaches.

## Key findings

- Chylothorax was identified as the initial manifestation of small cell lung carcinoma in a patient with a smoking history.
- CT imaging and pleural fluid analysis were critical in confirming the diagnosis and identifying mediastinal lymphadenopathy.
- Prolonged chyle drainage may worsen immunosuppression in cancer patients.

## Abstract

Chylothorax, the accumulation of lymphatic fluid in the pleural space, is a rare condition often linked to trauma, surgery or malignancy. We present the case of a 63‐year‐old female with a significant smoking history who was diagnosed with chylothorax as the initial manifestation of small cell lung carcinoma (SCLC). Diagnostic workup, including pleural fluid analysis and imaging, confirmed the diagnosis and revealed mediastinal lymphadenopathy and bronchial narrowing. The patient underwent chemotherapy, immunotherapy and management of recurrent effusions but ultimately succumbed to pneumonia and septic shock. Recognising chylothorax as a potential initial manifestation and understanding the risks of prolonged chyle drainage are crucial for effectively managing such complex cases.

Chylothorax can indeed be an initial manifestation of lung cancer. Non‐traumatic and non‐iatrogenic chylothorax requires thorough investigation, with computed tomography (CT) of the chest being a crucial diagnostic tool. Prolonged drainage of chylothorax can lead to exaggerated immunosuppression in malignancy.