Chylous Ascites due to Mantle Cell Lymphoma

Chylous ascites is rare and results in accumulation of lymph in the abdominal cavity, due to several mechanisms. The ascitic liquid is milky because of the high concentration of triglycerides (>200 mg/dl). The higher incidence compared to the past is explained by increased survival of patients with cancer and more aggressive surgery. We describe the case of an 87-year-old man admitted to the geriatric ward due to general oedema, chylous ascites and loss of weight, explained by mantle cell lymphoma. LEARNING POINTS: Chylous ascites is more frequent in trauma, but in some cases may be related to obstruction of the thoracic duct by retroperitoneal fibrosis, pancreatitis or neoplasms. It is a progressive, difficult to manage condition, with a spectrum of treatment ranging from a special diet to surgery. Its prognosis depends fundamentally on the predisposing condition.