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Chest Imaging

Pleural lymphoma

involvement of the pleura by either Hodgkins disease or non Hodgkins lymphoma. There may be nodular or plaque-like subpleural deposits of lymphomatous tissue or a pleural effusion due to obstruction of the lymphatics, pulmonary veins or thoracic duct, or as a result of direct pleural invasion. Primary pleural lymphoma is rare and pleural involvement is usually associated with mediastinal or pulmonary disease although disease recurrence is occasionally isolated to the pleura. Also, see pulmonary lymphoma, lymphoma recurrence thoracic).

A pleural effusion is seen on the chest radiograph in up to a quarter of patients with lymphoma at presentation and in an even higher proportion on CT, especially those with large mediastinal masses. Effusions are usually small unilateral exudates (although chylothorax can occur due to lymphatic obstruction) and they clear promptly with treatment. Subpleural masses of lymphoma may occur, lying just beneath the visceral pleura, but are uncommon. Such subpleural disease may appear as discrete nodules or plaques and there is frequently an associated pleural effusion. Lymphoma may extend into the extrapleural space with involvement of the chest wall. This is much better demonstrated by CT or MRI than chest radiography.

CF - HM