[A case of gastric cancer initially presented by bilateral chylothorax].

The patient, a 66-year-old woman, visited our hospital with chief complaints of nocturnal coughing and dyspnea. Chest radiography revealed bilateral pleural effusion, and she was admitted to our hospital to undergo more thorough examination. The bilateral pleural effusion was identified as chyle. In cytodiagnosis, a number of poorly-differentiated adenocarcinoma cells in clumps were detected, and mucus was found in the cell bodies. The case was diagnosed as signet-ring cell carcinoma. Endoscopy of the upper digestive tract was performed for close examination of the primary lesion. As a result, a IIc lesion accompanied with concentrated folds and hypertrophy was found on the anterior wall of the body of the stomach. Biopsy of this site led to a diagnosis of signet-ring cell carcinoma, and these results were consistent with the cytodiagnostic findings of pleural effusion. Because gastric carcinoma associated with bilateral chylothorax is very rare in Japan, we report the results of our study with some discussions based on a review of the literature.