Predominant T cells in pleural effusion of a patient with B-cell CLL

Pleural effusion is a relatively rare complication of chronic lymphatic leukemia (CLL). It can be the result of primary pleural involvement, central lymphatic blockage, infection or changes induced by previous irradiation or chemotherapy. When the effusion is caused by leukemic pleural infiltration, the lymphocytes are identical to those in the peripheral blood. We have recently treated a splenectomized patient with B-cell CLL who developed pleural effusion with predominant T cells. It is suggested that this might be due to a redistribution of the T cells in the recirculating lymphocytic pool in a patient who had undergone splenectomy in the past. The possible source of these cells in the pleural effusion is discussed.