Secondary involvement of the pleura with lymphoma

Last revised by Mohammad Taghi Niknejad on 5 Jul 2022

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. 

Up to 10% of malignant pleural effusions are due to non-Hodgkin lymphoma 1

Patients with secondary involvement of the pleural with lymphoma may present with dyspnoea (~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

Pleural effusions are more commonly seen than pleural thickening or pleural masses 4,5

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

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