{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:59:28Z","timestamp":1777949968084,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":122,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Oncological Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chylous ascites is an uncommon condition characterized by the accumulation of triglyceride\u2010rich, milky fluid in the peritoneal cavity due to lymphatic disruption or obstruction. Although lymphoma is a leading cause of malignant chylous ascites, its occurrence as an initial presentation remains rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 69\u2010year\u2010old woman presented with a three\u2010month history of postprandial abdominal pain, weight loss, anorexia, and dyspnea. Imaging revealed extensive abdominal and pelvic lymphadenopathy with bilateral pleural effusions. Diagnostic laparoscopy demonstrated milky peritoneal fluid, and fluid analysis confirmed chylous ascites (triglycerides, 1361\u2009mg\/dL). Lymph node biopsy demonstrated high\u2010grade B\u2010cell lymphoma with morphological features favoring follicular lymphoma. Immunohistochemistry revealed a markedly elevated Ki\u201067 proliferative index (&gt;\u200990%), and genomic profiling identified pathogenic\n                      <jats:italic>EZH2<\/jats:italic>\n                      and\n                      <jats:italic>TET2<\/jats:italic>\n                      mutations with a high tumor mutational burden. According to the fifth edition of the WHO Classification of Haematolymphoid Tumours (2022), these findings are most consistent with follicular lymphoma, a mature B\u2010cell neoplasm with high\u2010grade features. Given the high\u2010output drainage and recent surgery, cytotoxic chemotherapy was deferred, and rituximab monotherapy was initiated. Rapid clinical improvement and decreased drain output allowed safe transition to standard R\u2010CHOP therapy, achieving a complete metabolic response (Deauville score 2) after six cycles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights chylous ascites as a rare but important presenting feature of lymphoma. Its recognition should prompt early histopathologic evaluation and multidisciplinary management. In selected postoperative or frail patients, rituximab monotherapy can serve as an effective bridge to full chemotherapy, facilitating recovery and improving outcomes. Early diagnosis and targeted treatment remain essential to prevent complications from lymphatic loss and to optimize prognosis in lymphoma\u2010associated chylous ascites.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crom\/5559043","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:21:16Z","timestamp":1777872076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chylous Ascites: A Rare Initial Presentation of High\u2010Grade Follicular Lymphoma"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7150-9512","authenticated-orcid":false,"given":"Rama","family":"Nada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ani","family":"Gvajaia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Raza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Raji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.14218\/JCTH.2017.00035"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-96-3-358"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1067\/MSY.2000.109502"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/S10238-024-01312-4"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/JCM13154285"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/LYMPHATICS3010008"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.14309\/01.AJG.0001046068.05576.85"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.JVIR.2024.02.015"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/S13139-023-00813-6"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/BLOODADVANCES.2024014053"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4625819"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/AJH.26737"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/CANCERS15030785"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-10070-z"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/DIAGNOSTICS14151584"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.4175-24"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1478190"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.4021\/gr2008.12.1252"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002494"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(25)00034-1"}],"container-title":["Case Reports in Oncological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crom\/5559043","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crom\/5559043","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crom\/5559043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:21:17Z","timestamp":1777872077000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crom\/5559043"}},"subtitle":[],"editor":[{"given":"Jose I.","family":"Mayordomo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crom\/5559043"],"URL":"https:\/\/doi.org\/10.1155\/crom\/5559043","archive":["Portico"],"relation":{},"ISSN":["2090-6706","2090-6714"],"issn-type":[{"value":"2090-6706","type":"print"},{"value":"2090-6714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5559043"}}