Revision 3 for 'Secondary involvement of the pleura with lymphoma'

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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 extension of lymphoma into the visceral or parietal pleura or be a complicating pleural effusion, and is a poor prognostic factor. 


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 dyspnea (~60%), cough and/or chest pain. 


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 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

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