Primary Pleural Lymphoma with Dense Pleural Thickening.
Primary pleural lymphoma is an extremely rare disorder, accounting for 2.4% of primary chest wall tumors. The clinical manifestations and characteristic pleural thickening on thoracic computed tomography are clinical clues to the diagnosis. A case of primary pleural lymphoma, diffuse large B cell type, with thickened pleura and ipsilateral pleural effusion as
the initial presentation, is reported.
A 72-year-old man was referred to our hospital because of a 1-month history of persistent right chest pain. He had been in good health except for normal pressure hydrocephalus two years previously. He worked as a landscape gardener and had no illicit drug or dust exposure, including asbestos.
On initial examination, he appeared well, and vital signs and physical examination were normal. Chest X-ray showed a solitary nodule measuring 15 mm in size with an extrapleural sign in the right upper lung field, as well as blunting of the right costophrenic angle. Thoracic Computed Tomography confirmed the bulging nodule at the right parietal pleura and a bulky right pleural mass with a pleural effusion.
Both thoracic CT and Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography showed that the right pleural mass partially extended to the left pleura and invaded to the spinal canal through the right intervertebral foramen, which showed an intense Standardized Uptake Value of 28.5, suggesting malignancy. Serum laboratory examinations were normal except for mild anemia, mild elevation of Lactase Dehydrogenase, Creactive protein, and soluble interleukin-2 receptor.
Pulm Res Respir Med Open J. 2015; 2(2): 77-80. doi: 10.17140/PRRMOJ-2-112
