Intrathoracic manifestations in non-Hodgkin's lymphoma.

Manoharan, A.; Pitney, W. R.; Schonell, Malcolm; Bader, L V

doi:10.1136/thx.34.1.29

Cited by 54 publications

(20 citation statements)

References 8 publications

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“…In most of the cases, serous cavity involvement is part of a disseminated disease process, with predominance of other thoracic organ involvement. Among 86 NHL cases, Manoharan et al 38 found intrathoracic disease in 16 (19%). Paratracheal, mediastinal, and hilar lymphadenopathy were the commonest manifestations followed by pulmonary lesions and pleural effusions.…”

Section: Clinical Presentation and Imaging Findings In Lymphoma Patiementioning

confidence: 97%

Serous effusions in malignant lymphomas: A review

Das

2006

Diagnostic Cytopathology

213

237

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Serous effusions are a common complication of lymphomas. Although the frequency of pleural effusion is 20-30% in non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD), the involvement of peritoneal and pericardial cavities is uncommon. Among lymphoma subtypes, T-cell neoplasms, especially the lymphoblastic lymphomas, more frequently involve the serous fluids. The thoracic duct obstruction and impaired lymphatic drainage appear to be the primary mechanism for pathogenesis of pleural effusion in HD and direct pleural infiltration is the predominant cause in NHL. There is wide variation in rate of positive cytologic findings of NHL in pleural effusion (22.2-94.1%). Cytologic features of specific lymphoma subtypes such as lymphoblastic lymphoma, follicular center cell lymphoma, including Burkitt-type lymphoma, marginal zone lymphoma, MALT lymphoma, and anaplastic large-cell lymphoma, etc., have been described in the literature. The differential diagnostic problems of lymphomas in serous effusions include reactive lymphocytoses, early involvement by lymphomatous process, small round-cell tumors (SRCT), and presence of look-alike of Reed-Sternberg cells. To overcome these difficulties, various ancillary studies, including immunocytochemistry (ICC), morphometry, flow cytometry (FCM), and cytogenetics/molecular genetics (PCR, in-situ hybridization, and Southern blotting), have been performed on effusion specimens. ICC not only distinguishes lymphomas from reactive lymphocytoses and SRCTs, it significantly modifies the morphologic diagnosis to achieve a better classification of lymphomas. Combined morphology and immunophenotyping by FCM, has a sensitivity as well as specificity of 100%. Morphometry also distinguishes reactive lymphocytoses from malignant lymphoma with a high degree of sensitivity (>85%) and specificity (>95%). Limitations of individual ancillary techniques can be overcome by using multiple parameters. Although lymphomas rarely present as serous effusions without the involvement of other thoracic and extrathoracic sites, a small group of lymphomas called primary effusion lymphomas (PEL) exhibit exclusive or dominant involvement of serous cavities, without a detectable solid tumor mass. This body cavity based lymphoma (BCBL) is a distinct clinicopathologic entity and is found predominantly in AIDS patients with preexisting Kaposi sarcoma. In the absence of obstructive or infiltrative tumor mass, its pathogenesis has been attributed to stimulation by vascular endothelial growth factor (VEGF)/vascular permeability factor (VPF), leading to vascular leakage. Cytomorphologically, PEL is usually a large-cell lymphoma, which appears to bridge features of large-cell immunoblastic and anaplastic large-cell lymphoma (ALCL). Most of these cases comprise a unique subgroup of B-cell lymphoma, with features of both high-grade anaplastic and B-immunoblastic lymphoma, but T-cell and/or natural killer cell immunophenotypes are described. Its association with various viral DNAs has been studied in detail by molecular techn...

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Section: Clinical Presentation and Imaging Findings In Lymphoma Patiementioning

confidence: 97%

Serous effusions in malignant lymphomas: A review

Das

2006

Diagnostic Cytopathology

213

237

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“…3 Moreover, pericardial lesions readily cause cardiac tamponade manifested by hypotension. 4,5 Severe right cardiac failure developed first in our patient because the tumor mass occupied almost the entire space of the right atrial cavity and invaded its wall. Irradiation and chemotherapy are generally considered effective against malignant lymphoma; however, we decided to perform an emergency operation first due to the moribund condition of the patient.…”

Section: Discussionmentioning

confidence: 95%

Involvement of the Right Atrium by Malignant Lymphoma as a Cause of Right Cardiac Failure: Report of a Case

et al. 2000

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We describe herein a rare case of malignant lymphoma occupying almost the entire space of the right atrial cavity and causing low cardiac output syndrome. A life-saving emergency operation was carried out after the establishment of a temporary bypass between the axillary and femoral veins to prevent exacerbation of the patient's condition during the induction of anesthesia. Cardiopulmonary bypass was commenced and the right atrium was opened. A large tumor in the right atrium could not be completely removed due to invasion of the atrial wall. A bypass from the left innominate vein to the pulmonary arterial trunk was constructed with a prosthetic graft to convert the blood flow directly from the systemic vein to the pulmonary artery. Postoperative radiation treatment was given, which resulted in reducing the size of the tumor considerably, and the patient is doing well 1 year after his operation.

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“…5 The latter may consist of single or multiple nodules, pneumonic areas, or peribronchial infiltration 44-6 all cases being associated with extrathoracic manifestations of lymphoma in one study 4.…”

Section: Discussionmentioning

confidence: 99%

“…Previously it has been noted that there is an increased incidence of malignant lung tumours, particularly adenocarcinomas and bronchiolar-alveolar carcinomas, in fibrotic scars in the lung 23 Although intrathoracic involvement in non-Hodgkin’s lymphoma is common (occurring in about 10–25% of cases),4 5 it has not been described arising in an area of CFA.…”

Section: Discussionmentioning

confidence: 99%