Characteristics and prognostic value of pleural effusions in non-Hodgkin's lymphomas

The characteristics of 26 pleural effusions associated with non-Hodgkin's Lymphomas (NHL) have been analyzed (13% of the 200 NHL reviewed). Twenty-one of them were exudates and 5 chylous. Cytological examinations were positive in 18/21 of exudate effusions and so were 11 of the 15 pleural biopsies performed. Three of the chylous effusions were associated with chylous ascites, the pleural biopsy being positive in one case. In only 4 cases mediastinal adenopathies were found (3 exudates and one chylous). In half of the cases, the effusion disappeared as a response to chemotherapy. Intrapleural treatment with doxorubicin was performed in 6 patients with exudates, but the pleural effusion disappeared in only one case. The survival was shorter (estimated median survival, 6 months) in those patients in whom the pleural effusion did not disappear under systemic chemotherapy than in those in whom a response was achieved (estimated median survival greater than 40 months; p less than 0.01).