Longstanding pleural effusion in an elderly man due to non-Hodgkin's lymphoma (multilobulated nuclear cell type)

A 68-year-old man presented with left sided pleural effusion. Investigations were suggestive of non-Hodgkin's lymphoma of multilobulated nuclear cell type. Symptomatic treatment by repeated thoracic aspiration was carried out every three to four months over nine years, after which the patient developed left axillary lymphadenopathy and a chest wall mass. Biopsy of the mass revealed multilobulated B cell lymphoma. Complete remission including disappearance of the pleural fluid was achieved with combination chemotherapy. Pleural effusion was the only clinical feature of lymphoma for nine years and this has not been described before.