Lymphomas Involving the Pleura: A Clinicopathologic Study of 34 Cases Diagnosed By Pleural Biopsy

Abstract

Context.—Pleural involvement by lymphoma is relatively common. However, there are very few clinicopathologic studies reported in the literature of lymphomas involving the pleura. Objective.—To characterize the clinicopathologic features of lymphomas involving the pleura. Design.—We reviewed the clinicopathologic features of 34 patients with lymphoma involving the pleura proven by biopsy and classified these neoplasms using the World Health Organization classification. Results.—There were 22 men and 12 women, with an average age of 62 years (range, 22–82 years). Nine (26.5%) patients had pleural involvement as the only site of disease, 22 (64.7%) had other sites of involvement, and 3 (8.8%) had inadequate staging data. Eighteen (56.2%) of 32 patients with adequate clinical data had a history of lymphoma (including 3 patients with pleural involvement as the only disease site). In 29 (85.3%) cases, a specific diagnosis according to the World Health Organization classification could be made: 17 (58.6%) diffuse large B-cell lymphoma, 5 (17.2%) follicular lymphoma (including a case with areas of diffuse large B-cell lymphoma), 2 (6.9%) small lymphocytic lymphomas/chronic lymphocytic leukemia, 2 (6.9%) precursor T-cell lymphoblastic lymphoma/leukemia, 1 (3.4%) mantle cell lymphoma, 1 (3.4%) posttransplant lymphoproliferative disorder, and 1 (3.4%) classical Hodgkin lymphoma. The other 5 cases were B-cell lymphomas that could not be further classified. Cytologic examination of pleural fluid was performed in 15 cases and was positive for lymphoma in 8 (53.3%) cases. Conclusions.—Most patients with lymphoma involving the pleura have simultaneous evidence of systemic involvement. The most frequent type is diffuse large B-cell lymphoma, followed by follicular lymphoma. Cytologic examination can have negative results in patients with pleural involvement by lymphoma.

Diffuse Large B-cell Lymphoma Presenting as a Primary Pleural Mass: A Case Report and Literature Review

“…Our patient's primary presenting symptom was pleuritic pain, one of the most common presenting symptoms of both PAL and PEL, and she was also found to have a small pleural effusion [12]. Pleural effusions have been reported in roughly 25% of patients with NHL and are often misdiagnosed as either tuberculosis or tuberculous pleurisy [2,11,13]. Tuberculosis and tuberculous pleurisy are common misdiagnoses due to shared clinical characteristics with PPL including elevated adenosine deaminase levels, B symptoms, and fatigue [2,11].…”

Serous effusions in Burkitt lymphomas: a report of two paediatric cases with review of literature

“…4 Also, the most common subtype of lymphomas to present with effusions is diffuse large B-cell lymphoma (DLBCL), followed by follicular lymphoma. 5 In majority of the cases, serous effusions are present at the time of initial diagnosis and occur as a part of disease involving other sites. These effusions can be serous or serosanguinous, and are usually exudative in nature.…”

“…These effusions, when occurring in the pleura, are more common on the left side and show propensity for occurrence in males. 5 We present two cases of lymphomas, presenting with involvement of pleural and peritoneal cavities, respectively.…”

Extensive pleural involvement in pediatric T-Cell lymphoblastic lymphoma

“…The pleural involvement presentation reflects pleural irritation (chest pain or cough) or lung compression (dyspnea). [ 5 ] On CT, involvement of pleura can be seen as pleural effusion, plaques, and discrete pleural nodules. [ 6 ] Although imaging features are nonspecific and diagnosis may require a biopsy.…”