Secondary involvement of the pleura with lymphoma
Updates to Article Attributes
Body
was changed:
Secondary involvement of the pleura with lymphoma (secondary pleural lymphoma) is very common, occurring in ~20% of lymphomas. It may be a result of 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 1.
Clinical presentation
Patients with secondary involvement of the pleural with lymphoma may present with chest paindyspnoea (~60%), cough and/or dyspnoea chest pain.
Pathology
Pleural involvement may be unilateral or bilateral, and is more common the left 2.
Any type of lymphoma can be involved by large B-cell type is the most common 5. In Hodgkin lymphoma impaired lymphatic outflow by mediastinal lymphadenopathy and and in non-Hodgkin lymphoma direct pleural infiltration appear to be the underlying cause of pleural disease 3,4.
Radiographic features
Pleural effusions are more commonly seen than pleural thickening or pleural masses 4,5.
Treatment and prognosis
Presence of pleural effusion in lymphoma is considered a poor prognostic indicator 2. Systemic chemotherapy, talc pleurodesis and radiation therapy can be considered as treatment options 4.
Differential diagnosis
- primary pleural lymphoma
- differential diagnosis of a pleural effusion
- differential diagnosis of pleural thickening
See also
-<p><strong>Secondary involvement of the pleura with lymphoma</strong> is very common, occurring in ~20% <a title="Lymphomas" href="/articles/lymphoma">lymphomas</a>. It may be a result of extension of lymphoma into the visceral or parietal <a title="pleura" href="/articles/pleura">pleura</a> or be a complicating <a title="Pleural effusion" href="/articles/pleural-effusion">pleural effusion</a>. </p><h4>Epidemiology</h4><p>Up to 10% of <a title="malignant pleural effusions" href="/articles/malignant-pleural-effusions">malignant pleural effusions</a> are due to non-Hodgkin lymphoma <sup>1</sup>. </p><h4>Clinical presentation</h4><p>Patients with secondary involvement of the pleural with lymphoma may present with chest pain, cough and/or dyspnoea. </p><h4>Pathology</h4><p>Pleural involvement may be unilateral or bilateral, and is more common the left <sup>2</sup>.</p><p>Any type of lymphoma can be involved by large B-cell type is the most common <sup>5</sup>. In <a title="Hodgkin lymphoma" href="/articles/hodgkin-lymphoma">Hodgkin lymphoma</a> impaired lymphatic outflow by <a title="Mediastinal lymphadenopathy" href="/articles/mediastinal-lymph-node-enlargement">mediastinal lymphadenopathy</a> and in non-Hodgkin lymphoma direct pleural infiltration appear to be the underlying cause of pleural disease <sup>3,4</sup>. </p><h4>Radiographic features</h4><p>Pleural effusions are more commonly seen than <a title="Pleural thickening" href="/articles/pleural-thickening">pleural thickening</a> or <a title="Pleural mass - single" href="/articles/differential-of-a-single-pleural-mass">pleural masses</a> <sup>4,5</sup>. </p><h4>Treatment and prognosis</h4><p>Presence of pleural effusion in lymphoma is considered a poor prognostic indicator <sup>2</sup>. Systemic chemotherapy, talc pleurodesis and radiation therapy can be considered as treatment options <sup>4</sup>. </p><h4>Differential diagnosis</h4><ul>-<li><a title="Primary pleural lymphoma" href="/articles/primary-pleural-lymphoma">primary pleural lymphoma</a></li>-<li><a title="Differential diagnosis of a pleural effusion" href="/articles/pleural-effusion">differential diagnosis of a pleural effusion</a></li>-<li>differential diagnosis of <a title="Pleural thickening" href="/articles/pleural-thickening">pleural thickening</a>- +<p><strong>Secondary involvement of the pleura with lymphoma</strong> (<strong>secondary pleural lymphoma</strong>) is very common, occurring in ~20% of <a href="/articles/lymphoma">lymphomas</a>. It may be a result of extension of lymphoma into the visceral or parietal <a href="/articles/pleura">pleura</a> or be a complicating <a href="/articles/pleural-effusion">pleural effusion</a>, and is a poor prognostic factor. </p><h4>Epidemiology</h4><p>Up to 10% of <a href="/articles/malignant-pleural-effusions">malignant pleural effusions</a> are due to non-Hodgkin lymphoma <sup>1</sup>. </p><h4>Clinical presentation</h4><p>Patients with secondary involvement of the pleural with lymphoma may present with dyspnoea (~60%), cough and/or chest pain. </p><h4>Pathology</h4><p>Pleural involvement may be unilateral or bilateral, and is more common the left <sup>2</sup>.</p><p>Any type of lymphoma can be involved by large B-cell type is the most common <sup>5</sup>. In <a href="/articles/hodgkin-lymphoma">Hodgkin lymphoma</a> impaired lymphatic outflow by <a href="/articles/mediastinal-lymph-node-enlargement">mediastinal lymphadenopathy</a> and in non-Hodgkin lymphoma direct pleural infiltration appear to be the underlying cause of pleural disease <sup>3,4</sup>. </p><h4>Radiographic features</h4><p>Pleural effusions are more commonly seen than <a href="/articles/pleural-thickening">pleural thickening</a> or <a href="/articles/differential-of-a-single-pleural-mass">pleural masses</a> <sup>4,5</sup>. </p><h4>Treatment and prognosis</h4><p>Presence of pleural effusion in lymphoma is considered a poor prognostic indicator <sup>2</sup>. Systemic chemotherapy, talc pleurodesis and radiation therapy can be considered as treatment options <sup>4</sup>. </p><h4>Differential diagnosis</h4><ul>
- +<li><a href="/articles/primary-pleural-lymphoma">primary pleural lymphoma</a></li>
- +<li><a href="/articles/pleural-effusion">differential diagnosis of a pleural effusion</a></li>
- +<li>differential diagnosis of <a href="/articles/pleural-thickening">pleural thickening</a>
-</ul>- +</ul><h4>See also</h4><ul><li><a href="/articles/pleural-lymphoma">pleural lymphoma</a></li></ul>
References changed:
- 2. Vega F, Padula A, Valbuena JR et-al. Lymphomas involving the pleura: a clinicopathologic study of 34 cases diagnosed by pleural biopsy. Arch. Pathol. Lab. Med. 2006;130 (10): 1497-502. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17090191">Pubmed citation</a><span class="auto"></span>
- 3. Das DK. Serous effusions in malignant lymphomas: a review. Diagn. Cytopathol. 2006;34 (5): 335-47. <a href="http://dx.doi.org/10.1002/dc.20432">doi:10.1002/dc.20432</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/16604559">Pubmed citation</a><span class="auto"></span>
- 4. Management of malignant pleural effusions. Am. J. Respir. Crit. Care Med. 2000;162 (5): 1987-2001. <a href="http://dx.doi.org/10.1164/ajrccm.162.5.ats8-00">doi:10.1164/ajrccm.162.5.ats8-00</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/11069845">Pubmed citation</a><span class="auto"></span>
- 5. Feller AC, Diebold J, Lennert K. Histopathology of Non-Hodgkin's Lymphomas. Springer. ISBN:3540638016. <a href="http://books.google.com/books?vid=ISBN3540638016">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/3540638016">Find it at Amazon</a><span class="auto"></span>
- 1. Alexandrakis MG, Passam FH, Kyriakou DS et-al. Pleural effusions in hematologic malignancies. Chest. 2004;125 (4): 1546-55. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15078773">Pubmed citation</a><span class="auto"></span>
Systems changed:
- Chest
- Haematology
Tags changed:
- oncology
- cases
Images Changes:
Image 1 CT (C+ arterial phase) ( create )
Unable to process the form. Check for errors and try again.