Primary Effusion Lymphoma-like Lymphoma Mimicking Tuberculous Pleural Effusion: Three Case Reports and a Literature Review

Hayashino, Kenta; Meguri, Yusuke; Yukawa, Ryouya; Komura, Aya; Nakamura, Makoto; Yoshida, Chikamasa; Yamamoto, Kazuhiko; Oda, Wakako; Imajo, Kento

doi:10.2169/internalmedicine.1143-22

Cited by 2 publications

(3 citation statements)

References 40 publications

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“…Primary effusion lymphoma is a rare condition that often exhibits radiological images resembling those found in cases of pulmonary tuberculosis during examinations. 1,9 Despite its infrequency, radiologists need to consider the possibility of PEL as a potential diagnosis when encountering recurring cavity effusions during or after treatment with ATT. The primary manifestation observed in untreated NHL patients often involves lymphadenopathy in the mediastinal/hilar region and the occurrence of pleural effusion.…”

Section: Discussionmentioning

confidence: 99%

Rare Case of Primary Effusion Lymphoma mimicking Pulmonary Tuberculosis

Idris,

Gubali

2024

Jambura Med. and Health Sci J

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Primary effusion lymphoma (PEL) is a rare large B-cell non-Hodgkin lymphoma (NHL) that usually occurs in immunosuppressed individuals in advanced stages of the disease, presenting as body cavity effusions without detectable tumor mass. We report a 61-years old man presented to the emergency room complaining of effort-related dyspnoea, low-grade fever, night sweats, and a dry cough for several days. He was then put on empirical anti-tubercular treatment (ATT) suspecting Pulmonary Tuberculosis. General examination revealed a decrease oxygen saturation, tachypnea, a bulging tenderness lymph node on the neck. Chest computerized tomography (CT) scan indicated pericardial and pleural effusion with mediastinal dilatation suspected thymoma or lymphoma. A Cardiocentesis needle aspiration was performed; however, the histological pattern was not specific. The patient underwent a surgical biopsy of a left supra-clavicular lymph node. A Classical Hodgkin lymphoma nodular sclerosis type was found in the histopathology examination. Immunohistochemistry detected the tumour cellular markers (i.e., CD30). Chemotherapy treatment for 6 cycles resulted an excellent outcome. In conclusion, radiologists play a vital role in the diagnosis of PEL, detecting effusions in body cavities and excluding the existence of solitary masses or pleural nodules or masses, ultimately narrowing down the differential diagnoses.

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Section: Discussionmentioning

confidence: 99%

Rare Case of Primary Effusion Lymphoma mimicking Pulmonary Tuberculosis

Idris,

Gubali

2024

Jambura Med. and Health Sci J

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“…Another factor that contributed to this choice was the COVID-19 pandemic, as the patient was initially evaluated at a time when many hospital beds in Brazil were occupied with patients with COVID-19. Finally, it is worth highlighting primary effusion lymphoma-like lymphoma (PEL-LL), which is a possible complication of long-standing tuberculous pleuritis [ 21 ]. PELLL is a rare B-cell lymphoma characterized by the expression of pan B-cell markers (CD19, CD20, or CD 79a).…”

Section: Discussionmentioning

confidence: 99%

“…PELLL is a rare B-cell lymphoma characterized by the expression of pan B-cell markers (CD19, CD20, or CD 79a). Diagnosis of PELLL requires a long period of time because it follows a unique progression of disappearance and recurrence of the pleural effusion [ 21 , 22 ]. As a pleural biopsy was not performed, PEL-LL was not completely ruled out in the patient’s presentation.…”

Section: Discussionmentioning

confidence: 99%

Chocolate-Colored Pseudochylothorax in a Woman with a History of Pleuropulmonary Tuberculosis

Monnerat,

Louzada,

Braga

et al. 2023

Am J Case Rep

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Patient: Female, 55-year-old Final Diagnosis: Pseudochylothorax Symptoms: Dyspnea on exertion • fatigue Clinical Procedure: Ultrasound-guided thoracentesis Specialty: Pulmonology Objective: Rare disease Background: Pseudochylothorax is a rare entity, with only a few hundred case reports worldwide. It presents as a pleural effusion rich in lipids, typically with a cloudy, milky appearance. The diagnosis is made based on the levels of cholesterol and triglycerides in the pleural fluid. Case Report: This is the case report of a 55-year-old woman with a history of pleuropulmonary tuberculosis that was treated in childhood, with a new infection and treatment in adulthood that evolved to a left pleural effusion. Thirteen years after completing her last treatment for tuberculosis, the patient developed general fatigue and dyspnea on exertion. Computed tomography of the chest confirmed the presence of a pleural collection in the same location as in adolescence, suggesting a chronic evolution with encystation. The patient underwent ultrasound-guided diagnostic thoracentesis. The collected liquid was thick, chocolate-colored, with the following biochemical characteristics: pH, 7.3; glucose, 37.9 mg/dL; LDL, 2059.8 IU/L; total protein, 8.8 mg/dL; triglycerides, 90 mg/dL; adenosine deaminase, 56 U/L; and cholesterol, 300 mg/dL. The effusion was characterized as a pseudochylothorax. The cell count showed 631 000 leukocytes/µL, with 87.9% polymorphonuclear cells. Owing to the patient’s respiratory symptoms, an evacuatory thoracentesis was performed. After the procedure, the patient’s symptoms improved. Conclusions: Although pseudochylothorax is a rare condition, its possibility must always be kept in mind to avoid the hazards of misdiagnosis. In addition to the ‘classic’ milky and machine oil appearance, a chocolate-colored appearance should also serve as a clue to the diagnosis of pseudochylothorax.

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Primary Effusion Lymphoma-like Lymphoma Mimicking Tuberculous Pleural Effusion: Three Case Reports and a Literature Review

Cited by 2 publications

References 40 publications

Rare Case of Primary Effusion Lymphoma mimicking Pulmonary Tuberculosis

Rare Case of Primary Effusion Lymphoma mimicking Pulmonary Tuberculosis

Chocolate-Colored Pseudochylothorax in a Woman with a History of Pleuropulmonary Tuberculosis

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