Publique en esta revista
Información de la revista
Vol. 54. Núm. 8.Agosto 2018
Páginas 405-444
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 54. Núm. 8.Agosto 2018
Páginas 405-444
Clinical image
DOI: 10.1016/j.arbres.2017.10.002
Acceso a texto completo
Primary Pleural Lymphoma
Linfoma pleural primario
Visitas
153
Filipa Ramalho Fernandesa,
Autor para correspondencia
filipasrfernandes@gmail.com

Corresponding author.
, Rui Caetano Oliveirab, Luís Vaz Rodriguesa
a Department of Pneumology, Unidade Local de Saúde da Guarda E.P.E. – Hospital Sousa Martins, Portugal
b Department of Anatomical Pathology, Centro Hospitalar e Universitário de Coimbra, Portugal
Este artículo ha recibido
153
Visitas
Información del artículo
Texto Completo
Bibliografía
Descargar PDF
Estadísticas
Figuras (1)
Texto Completo

A 80-year-old male, smoker, presented with chronic complaints of dyspnoea, anorexia and asthenia. Lung sounds were absent on the lower two-thirds of the right hemithorax.

Chest computed tomography (CT) (Fig. 1A) confirmed the presence of extensive right pleural effusion, without mediastinal or hilar lymphadenopathies.

Fig. 1.

(A) Chest CT (axial plan (AP)): extensive right pleural effusion conditioning almost complete atelectasis of the middle and lower lobes. No mediastinal or hilar pulmonary lymphadenopathies were found. (B) Medical thoracoscopy: pericentrimetric macular lesions with multifocal distribution and stony consistency. (C) Small to intermedium lymphocytes with nuclear irregularity, admixed with mesothelial cells, H&E 400×. (D) Diffuse expression of CD20 in the neoplastic cells, 400×.

(0,22MB).

Thoracentesis revealed an exudative pleural effusion with absence of malignant cells.

Medical thoracoscopy allowed the visualization and biopsy of multifocal parietal pleural based pericentimetric macular lesions (Fig. 1B). Histopathological examination revealed small and intermediate cells (Fig. 1C), with eosinophilic cytoplasm and mild nuclear irregularity with occasional nucleoli, expressing CD20 (Fig. 1D), Bcl2, Bcl6, PAX5 and CD70a, CD10, MUM1 and p53; there was no expression of CD5 and TTF1; MIB-1 proliferative index was 50%. There was also mesothelial cells hyperplasia, with eosinophils.1,2

Neck, abdomen and bone positron emission CT showed no abnormalities.

A final diagnosis of primary pleural lymphoma (PPL) was made and chemotherapy was started. PPL is a rare cause of pleural effusion and its endoscopic appearance has seldom been fully characterized (both as multifocal nodular lesions and diffuse unspecified pleural involvement).3,4 The clinical manifestations are unspecific and large biopsy samples are the key to the diagnosis, allowing for extensive immunohistochemical analysis.

References
[1]
W.D. Travis, E. Brambilla, A.P. Burke, A. Marx, A.G. Nicholson, W.D. Travis
WHO classification of tumours of the lung, pleura, thymus and heart
fourth edition, IARC, (2015)
[2]
S. Patel, P. Xiao
Primary effusion lymphoma
Arch Pathol Lab Med, 137 (2013), pp. 1152-1154 http://dx.doi.org/10.5858/arpa.2012-0294-RS
[3]
M. Sun, B. Shang, J. Gao, S. Jian
Rare case of primary pleural lymphoma presenting with pleural effusion
Thoracic Cancer, (2016), pp. 145-150
[4]
H. Ahmad, J. Pawade, S. Falk, J.A. Morgan, L. Blacumaraswami
Primary pleural lymphomas
Thorax, 58 (2003), pp. 908-909
Copyright © 2017. SEPAR
Idiomas
Archivos de Bronconeumología

Suscríbase a la newsletter

Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.