Bilateral chylothorax due to retrosternal goiter in a patient with non-Hodgkin's lymphoma

Chylous pleural effusion, or chylothorax, usually results from obstruction to or disruption of the thoracic duct. Malignant etiologies are the most co mmon cause of chylothorax, lymphoma accounting for the majority of non-trau matic chylous effusions. We report an unusual case of bilateral chylothorax associated with a retrosternal toxic multinodular goiter in a patient with non-Hodgkin's lymphoma. An ablative dose of I-131 was administered with ap parent initial clinical improvement. The pathogenesis of chylothorax and th erapeutic considerations are discussed.