Secondary involvement of the pleura with lymphoma
Secondary involvement of the pleura with lymphoma (secondary pleural lymphoma) is very common, occurring in ~20% of lymphomas. It may be a result of an extension of lymphoma into the visceral or parietal pleura or be a complicating pleural effusion and is a poor prognostic factor.
Epidemiology
Up to 10% of malignant pleural effusions are due to non-Hodgkin lymphoma .
Clinical presentation
Patients with secondary involvement of the pleural with lymphoma may present with dyspnea (~60%), cough and/or chest pain.
Pathology
Pleural involvement may be unilateral or bilateral and is more common the left .
Any type of lymphoma can be involved by large B-cell type is the most common . In Hodgkin lymphoma impaired lymphatic outflow by mediastinal lymphadenopathy and in non-Hodgkin lymphoma direct pleural infiltration appear to be the underlying cause of pleural disease .
Radiographic features
Pleural effusions are more commonly seen than pleural thickening or pleural masses .
Treatment and prognosis
Presence of pleural effusion in lymphoma is considered a poor prognostic indicator . Systemic chemotherapy, talc pleurodesis and radiation therapy can be considered as treatment options .
Differential diagnosis
- primary pleural lymphoma
- differential diagnosis of a pleural effusion
- differential diagnosis of pleural thickening
See also
