Intrathoracic Manifestations of the Lymphomatoid Diseases

Vieta, John O.; Craver, Lloyd F.

doi:10.1148/37.2.138

Cited by 114 publications

(25 citation statements)

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“…According to reports in the early 1940s, in Hodgkin9s disease, pleural effusions develop in 16% of patients and pleural thickening in 7%; the figures were, 15% and 11% in non-Hodgkin9s lymphoma and 2% and 4% in leukaemia, respectively [11]. Later observations have differed.…”

Section: Lymphoma Leukaemia and Multiple Myelomamentioning

confidence: 99%

“…The main cause of effusion, which may be unilateral or bilateral, is obstruction of the lymphatic drainage by enlarged mediastinal lymph nodes in Hodgkin9s disease and by direct tumour infiltration of the parietal or visceral pleura in non-Hodgkin9s lymphoma [11,[192][193][194]. The effusion is usually an exudate but may occasionally have transudative characteristics.…”

Section: Lymphoma Leukaemia and Multiple Myelomamentioning

confidence: 99%

“…In one post mortem series, malignant effusions were found in 15% of patients who died with malignancies [1]. Although there have been no epidemiological studies, the annual incidence of malignant pleural effusions in the United States is estimated to be w150,000 cases (table 1) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Malignant pleural effusion is also one of the leading causes of exudative effusion; studies have demonstrated that 42-77% of exudative effusions are secondary to malignancy [18,19].…”

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Management of malignant pleural effusions

et al. 2001

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Section: Lymphoma Leukaemia and Multiple Myelomamentioning

confidence: 99%

Section: Lymphoma Leukaemia and Multiple Myelomamentioning

confidence: 99%

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Management of malignant pleural effusions

et al. 2001

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“…Up to 16% of patients with Hodgkin and non-Hodgkin lymphoma will have a pleural effusion during their illness, occurring as either a presenting feature or later on in the disease course [3,4]. The mechanisms of pleural effusion include pleural infiltration by the tumour, lymphatic obstruction, secondary heart failure, renal failure, and hypoalbuminaemia [5].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study to Evaluate a Diagnostic Algorithm for the Use of Fluid Lymphocyte Subset Analysis in Undiagnosed Unilateral Pleural Effusions

et al. 2017

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Background: Haematological malignancy is an important cause of pleural effusion. Pleural effusions secondary to haematological malignancy are usually lymphocyte predominant. However, several other conditions such as carcinoma, tuberculosis, and chronic heart failure also cause lymphocytic effusions. Lymphocyte subset (LS) analysis may be a useful test to identify haematological malignancy in patients with lymphocytic effusions. However, research into their utility in pleural effusion diagnostic algorithms has not yet been published. Objectives: We aimed to determine the clinical utility of pleural fluid LS analysis and whether it can be applied to a diagnostic algorithm to identify effusions secondary to haematological malignancy. The secondary aim was to evaluate the diagnostic value of pleural fluid differential cell count. Methods: Consecutive consenting patients presenting to our pleural service between 2008 and 2013 underwent thoracentesis and differential cell count analysis. We proposed an algorithm which selected patients with lymphocytic effusions (>50%) to have further fluid sent for LS analysis. Two independent consultants agreed on the cause of the original effusion after a 12-month follow-up period. Results: A total of 60 patients had samples sent for LS analysis. LS analysis had an 80% sensitivity (8/10) and a 100% specificity for the diagnosis of haematological malignancy. The positive and negative predictive values were 100 and 96.1%, respectively. Overall 344 differential cell counts were analysed; 16% of pleural effusions with a malignant aetiology were neutrophilic or eosinophilic at presentation. A higher neutrophil and eosinophil count was associated with benign diagnoses, whereas a higher lymphocyte count was associated with malignant diagnoses. Conclusions: LS analysis may identify haematological malignancy in a specific cohort of patients with undiagnosed pleural effusions. A pleural fluid differential cell count provides useful additional information to streamline patient pathway decisions.

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“…There is good radiological and postmortem evidence that this occurs both by direct invasion from adjacent lymph nodes and by lymphatic or haematogenous dissemination from distant sites (Filly et al, 1976;Robbins, 1953;Stolberg et al, 1964;Vieta & Craven, 1941). However, histological evidence of early intrathoracic spread has been inadequate compared with that available for the involvement of the intrabdominal organs (Kaplan, 1980;Peckham, 1973;Rosenberg et al, 1961;Sugarbaker & Craven, 1940;Filly et al, 1976;Robbins, 1953;Stolberg et al, 1954;Vieta & Craven, 1941;Goffinet et al, 1977).…”

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Early involvement of the bronchi in patients with malignant lymphoma

Gallagher¹,

Knowles²,

Habeshaw³

et al. 1983

Br J Cancer

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Fibreoptic bronchoscopy in previously untreated patients with malignant lymphoma provided diagnostic information in 8 of 25 cases with radiological evidence of intrathoracic involvement. There was a marked difference in the pattern of endobronchial involvement between Hodgkin's Disease (HD) and Non Hodgkin's Lymphoma (NHL) which specifically infiltrated the bronchus-associated lymphoid tissue. Bronchoalveolar lavage was abnormal in only one patient with Hodgkin's Disease in whom the presence of many Sternberg-Reed cells suggested occult dissemination of otherwise localised disease. Images Figure 1 Figure 2

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Intrathoracic Manifestations of the Lymphomatoid Diseases

Cited by 114 publications

References 2 publications

Management of malignant pleural effusions

Management of malignant pleural effusions

A Prospective Study to Evaluate a Diagnostic Algorithm for the Use of Fluid Lymphocyte Subset Analysis in Undiagnosed Unilateral Pleural Effusions

Early involvement of the bronchi in patients with malignant lymphoma

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