Rapid Onset Chylous Ascites Presenting as the Initial Manifestation of Follicular Lymphoma: A Case Report.

Follicular lymphoma is the most common indolent Non-Hodgkin Lymphoma (NHL) with overall survival measured in years for the majority of patients (NHL carries a somewhat positive prognosis). Baseline clinical genetic characteristics appear to be the best predictors of the clinical course. A few cases appear to be familial; however, no consistent environmental or infectious causation has been identified. Our presenting patient has a case of follicular lymphoma that was initially diagnosed in the setting of rapid onset chylous ascites, a highly atypical and rare presentation. Follicular lymphoma typically presents with painless lymphadenopathy in lymph nodes along the torso. The lymphoma cells divide within the nodes and can be palpated as bumps within the axilla or on the neck above the clavicle. Various prognostic indicators and tumor grading can give providers a sense of survival statistics. Once diagnosed, chemotherapy tends to form the backbone of most treatment regimens with various roles for immunotherapy and radiation.