Clinical analysis of 11 cases of lymphoma first diagnosed with pleural effusion
2019
Objective
Toanalyze the clinical characteristics oflymphoma presented with pleural effusion.
Methods
The clinical data of lymphoma (11 cases) with pleural effusion as the main manifestation of Beijing Hospital from 2009 to 2017 were retrospectively analyzed.
Results
Male/female ratio was 0.83∶1, and the M(QR) of age was 66(42) years old.Mature B cell neoplasm was diagnosed in 10 cases, while mature T and natural killer cell neoplasm was diagnosed in 1 case.The main symptoms were dyspnea, fever and cough.Superficial lymphadenopathy and hepatosplenomegaly were the most common signs.The imaging findings were diverse.Lymph node enlargementwas common.Ground-glass opacity, nodules or masses were also seen.Pleural lesions were seen in only 2 cases.Anemia and elevated serumlactate dehydrogenase (LDH) were common.LDH was 376(317) U/L.The appearance of pleural effusion was yellow, bloody or chyloid.Bilateral pleural effusion was found in 9 cases.Exudate effusion was found in 10 cases.The ratio of single nucleusin pleural effusion was 94.7%(41.0%) and increased in 10 patients.Adenosine deaminase (ADA) in pleural effusion was 31.45(81.88) U/L in 8 cases, and ADA in pleural effusion was >40 U/L in 4 cases.Pleural effusion/serum protein was 0.66(0.26), pleural effusion/serum LDH was 1.03(0.59), serum LDH/pleural effusion ADA was 22.85(50.29). Malignant cells were found in pleural effusion at the first time of thoracic puncture in 6 cases.In other 3 cases, tumor cells were found in pleural effusion at 2 months, 6 months and 19 months after diagnosis.
Conclusions
The clinical manifestations of lymphoma presented with pleural effusionisno specificity.The physicochemical properties of pleural effusion are difficult to differentiate from tuberculous pleurisy.It is of great significance to find tumor cells in pleural effusion, but lymphoma cannot be ruled out completely without finding tumor cells.Suspicious patients need to be repeatedly examined and undergo biopsy.
Key words:
Lymphoma; Pleural effusion
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