Pleural Effusions in Diffuse Large B-Cell Lymphoma: Clinical and Prognostic Significance
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Pleural effusion (PEs) may complicate diffuse large B-cell lymphomas (DLBCL). However, their real prevalence and prognostic significance have seldom been approached systematically.
Retrospective single-center evaluation of consecutive patients with DLBCL was conducted. Baseline characteristics, PEs on CT imaging, pleural fluid analyses, and outcome until death or censoring date were collected.
Of 185 DLBCL patients, 55 (30%) had PEs, of which 27 (49%) were analyzed. Most tapped PEs were malignant (n = 24) and cytological and/or flow cytometric analyses provided the diagnosis in about 70% of the cases. Malignant PEs were exudates with adenosine deaminase levels > 35 U/L in 35% of the cases. More than one-third of lymphomatous PEs required definitive pleural procedures for symptomatic relief. PEs greater than 200 mL on CT scans were an independent predictor of poor survival in Cox regression modeling (hazard ratio 1.9).
PEs are common in DLBCL and foreshadow a poor prognosis.
KeywordsPleural effusion Diffuse large B-cell lymphoma Survival Indwelling pleural catheter Pleurodesis Adenosine deaminase Chylothorax
Conception and design: JMP and SB; Acquisition, analysis and interpretation of data: IC, TGC, MP, SB, and JMP; and drafting the manuscript: JMP All authors gave final approval.
Compliance with Ethical Standards
Conflict of interest
None of the authors has any conflicts of interest to declare in relation to this work.
- 4.Laurent C, Do C, Gourraud PA, de Paiva GR, Valmary S, Brousset P (2015) Prevalence of common non-Hodgkin lymphomas and subtypes of Hodgkin lymphoma by nodal site of Involvement: a systematic retrospective review of 938 cases. Medicine 94:e987. https://doi.org/10.1097/MD.0000000000000987 CrossRefGoogle Scholar
- 6.Clive AO, Kahan BC, Hooper CE, Bhatnagar R, Morley AJ, Zahan-Evans N, Bintcliffe OJ, Boshuizen RC, Fysh ET, Tobin CL, Medford AR, Harvey JE, van den Heuvel MM, Lee YC, Maskell NA (2014) Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax 69:1098–1104. https://doi.org/10.1136/thoraxjnl-2014-205285 CrossRefGoogle Scholar
- 7.Lu CS, Chen JH, Huang TC, Wu YY, Chang PY, Dai MS, Chen YC, Ho CL (2015) Diffuse large B-cell lymphoma: sites of extranodal involvement are a stronger prognostic indicator than number of extranodal sites in the rituximab era. Leuk Lymphoma 56:2047–2055. https://doi.org/10.3109/10428194.2014.982636 CrossRefGoogle Scholar