title: The CT appearance of pleural and extrapleural disease in lymphoma.
abstract: OBJECTIVE
  Pleural effusions in patients with lymphoma that are assumed to be related to malignancy are attributed to either lymphatic obstruction by tumour with resultant decreased clearance of pleural fluid, or direct tumour involvement of the pleura. The purpose of our study was to determine how often pleural or extrapleural disease was detected by computed tomography (CT) of patients with pleural effusions and primary or recurrent lymphoma.
  
  
  METHODS
  We reviewed CT examinations showing evidence of pleural effusion in 61 patients with a diagnosis of primary or recurrent lymphoma and no history of other systemic disorders, including infection. The study population consisted of patients with non-Hodgkin's lymphoma (n = 44) or Hodgkin's disease (n = 17); both primary disease (n = 11) and recurrent disease (n = 50) were represented. Each CT examination was evaluated for the presence of disease involving the visceral and parietal pleura and extrapleural space, mediastinal adenopathy, and pulmonary parenchymal disease.
  
  
  RESULTS
  Fourteen patients (23%) (nine with non-Hodgkin's lymphoma and five with Hodgkin's disease) had parietal pleural disease (thickening or nodules). Eighteen patients (30%) (14 with non-Hodgkin's lymphoma, four with Hodgkin's disease) had tumour or enlarged lymph nodes in the extrapleural space. Forty-three patients (70%) had mediastinal lymphadenopathy. Patients who received intravenous contrast did not have evidence of visceral pleural abnormalities or underlying pulmonary parenchymal disease.
  
  
  CONCLUSIONS
  Forty-one percent of the patients with lymphoma and pleural effusions had CT evidence of pleural and/or extrapleural disease. The majority of the patients with extrapleural disease had adjacent posterior mediastinal disease.
authors.affiliation: Department of Radiology FND 202, Massachusetts General Hospital, Boston 02114-2698, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Aquino
authors.forename: M Y
authors.initials: MY
authors.lastname: Chen
authors.forename: W T
authors.initials: WT
authors.lastname: Kuo
authors.forename: C
authors.initials: C
authors.lastname: Chiles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging*; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000000981:diagnostic imaging*; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed