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Successful Thalidomide Treatment of Persistent Chylous Pleural Effusion
- Rachel Pauzner, MD;
- Haim Mayan, MD;
- Ana Waizman, MD;
- Judith Rozenman, MD; and
- Zvi Farfel, MD
- From Sheba Medical Center and Tel Aviv University, Tel Hashomer, Israel.
Background: Disseminated lymphangiomatosis is characterized by proliferation of lymph vessels in soft tissues, viscera, or bones (1). Chylothorax is a serious manifestation and is typically refractory to several interventions, including chemical pleurodesis, surgical ligation of the thoracic duct, pleuroperitoneal shunt, radiation therapy, pleurectomy, chest wall resection, and antiestrogen drug therapy (2). It is associated with a poor prognosis. Interferon, which is antiangiogenic, has been used successfully in life-threatening hemangiomatosis of infancy and in some cases of disseminated lymphangiomatosis (3, 4). Thalidomide has immunomodulatory, anti-inflammatory, and antiangiogenic properties (5). In experimental models, thalidomide inhibits angiogenesis that is induced by vascular endothelial growth factor and fibroblast growth factor (5).
Objective: To describe the use of thalidomide in a patient with disseminated lymphangiomatosis and persistent chylous pleural …
