Significance of pleural effusion at diagnosis in pediatric Hodgkin lymphoma: a report from Children’s Oncology Group protocol AHOD0031

McCarten, Kathleen; Metzger, Monika L.; Drachtman, Richard A.; Pei, Qinglin; Friedman, Debra L.; Schwartz, Cindy L.; Kelly, Kara M.

doi:10.1007/s00247-018-4197-6

Cited by 18 publications

(27 citation statements)

References 19 publications

(26 reference statements)

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“…The frequency of effusion lymphomas occurring concurrently at initial disease presentation varies in different series, ranging from 11.7% to 15.0% for pediatric newly diagnosed CHL, 10,12 to 30.0% of newly diagnosed DLBCL, 11 and 71.4% of lymphoblastic lymphoma 12 . Large mediastinal lymphadenopathy, higher serum levels of lactate dehydrogenase (LDH) and serum β‐2 microglobulin were reported to be associated with a higher incidence of effusion lymphomas 10,11 . In a study of 90 pediatric patients with acute lymphoblastic leukemia from Turkey, 26% (23 cases) had malignant pericardial effusions, including 74% B‐ and 26% T‐lineage neoplasms, respectively 13 .…”

Section: Discussionmentioning

confidence: 99%

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The cytopathological spectrum of lymphomas in effusions in a tertiary center in Taiwan

Wang

Chen

et al. 2020

Diagnostic Cytopathology

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BackgroundLymphomas presenting in effusions could either be primary or secondary, with very limited data from Taiwan.MethodsWe retrospectively reviewed effusion lymphomas from our archives in a tertiary center from July 2011 to June 2019.ResultsWe identified 59 specimens from 43 patients, including 7 cases with primary effusion lymphoma (PEL) and 36, secondary effusion involvement. Half of the secondary cases presented concurrently with effusion lymphoma, while the remaining half‐experienced effusion lymphoma during disease progression. All patients with PELs were males with a median age of 77 and presented with massive pleural effusion. None was HIV‐related. Two (29%) PEL cases were positive for human herpes virus 8 (HHV8). The only case with plasmablastic phenotype in the PEL group was positive for both HHV8 and EBV. Four patients died shortly after diagnosis; while the remaining three were alive at the last follow‐up (two at 13 months and one at 99 months). Of the secondary cases, diffuse large B‐cell lymphoma/high grade B‐cell lymphoma was the most common (n = 16, 44%), followed by mantle cell lymphoma (n = 5, 14%). Only 8 cases (22%) were T‐cell neoplasms. Prognosis for patients with secondary effusion involvement was dismal, with 1‐ and 2‐year overall survival rates at 17% and 8%, respectively.ConclusionWe found a wide cytopathological spectrum of effusion lymphoma in Taiwan. Most of our PEL cases were distinct from that defined in the World Health Organization scheme by a B‐cell phenotype, HHV8‐negativity, and absence of immunodeficiency. As compared to PEL cases, the prognosis of those with secondary involvement was extremely poor.

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Section: Discussionmentioning

confidence: 99%

“…Around 10% to 15% cases of malignant PE are caused by hematologic malignancy 5‐7 . Both Hodgkin and non‐Hodgkin lymphoma may cause malignant effusion, either as initial presentation or at disease progression/relapse 2,8‐13 . The relative frequencies of lymphoma types in malignant effusion differ in various studies.…”

Section: Introductionmentioning

confidence: 99%

The cytopathological spectrum of lymphomas in effusions in a tertiary center in Taiwan

Wang

Chen

et al. 2020

Diagnostic Cytopathology

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“…Patients with pleural involvement have poor clinical outcomes (24)(25)(26)(27). Our study revealed that pleural involvement is an independent prognostic factor for PFS and OS in both patients with pulmonary B-cell NHLs and the PPL subgroup.…”

Section: Discussionmentioning

confidence: 62%

The characteristic computed tomography findings of pulmonary B-cell non-Hodgkin’s lymphoma and their role in predicting patient survival

Wang¹,

Pan²,

Zhu³

et al. 2021

Quant Imaging Med Surg

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Background: To assess the value of characteristic computed tomography (CT) findings in predicting the survival of patients with pulmonary B-cell non-Hodgkin's lymphoma (NHL).Methods: Eighty-four patients who were histopathologically confirmed with pulmonary B-cell NHL between 2004 and 2018 were retrospectively enrolled. All patients underwent chest CT scan at the time of initial diagnosis in our hospital. Characteristic CT findings and clinicopathological features of the patients were analyzed, and Cox regression models were used to determine the relationship of CT findings with overall survival (OS) and progression-free survival (PFS).Results: Air bronchogram occurred more frequently in patients with early-stage disease, primary pulmonary lymphoma (PPL) and the indolent histological type of lymphoma than in patients with advancedstage disease, secondary pulmonary lymphoma (SPL), and the aggressive histological type (all P<0.05). The halo sign was observed most in the SPL group (19/48, 40%; P=0.004), while the presence of cross-lobe sign was higher in patients with PPL (13/36, 36%; P=0.010). Pleural involvement and hilar/mediastinal lymphadenopathy were observed more in patients with SPL and the aggressive histological type (33/48 and 27/48; 31/46 and 26/46, respectively; all P<0.05). Survival analyses showed that the number of lung lesions, cross-lobe sign, and pleural involvement were independent prognostic factors for PFS, while the halo sign and pleural involvement were significantly correlated with OS (all P<0.05). More aggressive, advanced-stage cases and male patients showed worse outcomes. Conclusions:The halo sign and pleural involvement are independent prognostic factors for OS, while the number of lung lesions, cross-lobe sign, and pleural involvement are correlated with PFS.

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“…Although malignancy is a rare cause, pleural effusion may be seen at diagnosis in 15% of children with non-Hodgkin lymphoma and is a marker for poor therapeutic response and relapse. Suggested causes include venous obstruction from bulky disease, leading to a decreased venous return to the heart and reduced lymphatic drainage of the thoracic duct if the left brachiocephalic vein is involved [45]. Pleural effusions are readily demonstrated on chest radiography and pleural ultrasound, with the latter able to assess the complexity, and approximate size of the effusion.…”

Section: Intra-thoracic Emergenciesmentioning

confidence: 99%

Emergency imaging in paediatric oncology: a pictorial review

et al. 2019

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Despite the decline in mortality rates over the last 20 years, cancer remains one of the leading causes of death in children worldwide. Early recognition and treatment for acute oncological emergencies are vital in preventing mortality and poor outcomes, such as irreversible end-organ damage and a compromised quality of life. Imaging plays a pivotal and adjunctive role to clinical examination, and a high level of interpretative acumen by the radiologist can make the difference between life and death. In contrast to adults, the most accessible crosssectional imaging tool in children typically involves ultrasound. The excellent soft tissue differentiation allows for careful delineation of malignant masses and along with colour Doppler imaging, thromboses and large haematomas can be easily identified. Neurological imaging, particularly in older children is an exception. Here, computed tomography (CT) is required for acute intracranial pathologies, with magnetic resonance imaging (MRI) providing more definitive results later. This review is divided into a 'body systems' format covering a range of pathologies including neurological complications (brainstem herniation, hydrocephalus, spinal cord compression), thoracic complications (airway obstruction, superior vena cava syndrome, cardiac tamponade), intra-abdominal complications (bowel obstruction and perforation, hydronephrosis, abdominal compartment syndrome) and haematological-related emergencies (thrombosis, infection, massive haemorrhage). Within each subsection, we highlight pertinent clinical and imaging considerations. The overall objective of this pictorial review is to illustrate how primary childhood malignancies may present with lifethreatening complications, and emphasise the need for imminent patient management.

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Significance of pleural effusion at diagnosis in pediatric Hodgkin lymphoma: a report from Children’s Oncology Group protocol AHOD0031

Cited by 18 publications

References 19 publications

The cytopathological spectrum of lymphomas in effusions in a tertiary center in Taiwan

The cytopathological spectrum of lymphomas in effusions in a tertiary center in Taiwan

The characteristic computed tomography findings of pulmonary B-cell non-Hodgkin’s lymphoma and their role in predicting patient survival

Emergency imaging in paediatric oncology: a pictorial review

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