Primary pleural lymphomas

Our plain-English summary of Primary pleural lymphomas, by H. Ahmad, J. Pawade, S. Falk, et al (Thorax, 2003).

The study

• Authors: H. Ahmad, J. Pawade, S. Falk, J.A. Morgan, L. Balacumaraswami
• Journal: Thorax
• Published: 2003;58(10):908-9
• Type of article: Case report
• Cited by: 26 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Two patients are presented with primary low grade pleural B cell lymphomas with no history of a pyothorax.

In plain English

This case report from Bristol, UK, described two patients with primary low grade B cell lymphoma of the pleura (the lining around the lungs). Neither had a history of pyothorax (pus in the chest cavity). The first patient, a 59-year-old non-smoking man, had occupational asbestos exposure from over 30 years of work in power stations. The article did not name a fiber type. His CT scan showed fluid on the left side, thickened pleura, and calcification on both sides suggestive of asbestos exposure. Biopsy showed low grade marginal zone lymphoma of the pleura, with lymphoma infiltrating hyalinised plaques. The authors noted that the asbestos history had suggested mesothelioma as the most likely diagnosis. After chlorambucil treatment, follow-up at 18 months showed no enlarged lymph nodes and no return of the fluid. The second patient, a 49-year-old non-smoker who had tuberculosis at age 18, had the same lymphoma type. After chlorambucil and prednisolone, he had no enlarged lymph nodes and no return of the fluid at 14 months. The authors suggested that past asbestos exposure and tuberculosis may have provided a focus of inflammation. They said the role of tuberculosis in the second case was unclear.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (two patients)
• Who was studied: Two patients treated at Bristol Royal Infirmary, UK: a 59-year-old non-smoking man and a 49-year-old non-smoker. Dates are not given.
• Exposure: Patient 1 had occupational asbestos exposure from working in power stations for over 30 years. No fiber type is given. Patient 2 had tuberculosis diagnosed at age 18, and no asbestos exposure is reported for him.
• Main results:
  • Patient 1: CT showed a left pleural effusion with irregular parietal pleural thickening, and bilateral pleural calcification suggestive of asbestos exposure.
  • Patient 1: the pleural biopsy supported a diagnosis of low grade marginal zone lymphoma of the pleura. Hyalinised plaques infiltrated by lymphoma were also present in the sample.
  • Patient 1: after treatment with chlorambucil, follow-up at 18 months showed no lymphadenopathy and no recurrence of the effusion.
  • Patient 2: the pleural lymphoma was the same low grade marginal zone type. After chlorambucil and prednisolone, there was no lymphadenopathy and no recurrence of the effusion at 14 months.
  • The authors noted that in patient 1 the history of asbestos exposure had suggested mesothelioma as the most likely diagnosis.
• The authors' conclusion: The authors described two cases of low grade non-Hodgkin's lymphoma of the pleura without pyothorax, one with a background of asbestos exposure and one with a history of tuberculosis. They suggested that the previous asbestos exposure and tuberculosis may have provided a focus of inflammation.
• Limitations the authors state:
  • For patient 2, the site of the original tuberculosis is not known, so its role in the later lymphoma is unclear.

Topics

Medical terms in this study, explained in our Lexicon: Empyema.

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