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Pleural effusions in lymphoblastic lymphoma: a diagnostic alternative
B E Chaignaud1, T A Bonsack, H P Kozakewich
1Department of Surgery, Children's Hospital/Harvard Medical School, Boston, MA 02115, USA.
Journal of Pediatric Surgery
|October 10, 1998
Summary
Children with anterior mediastinal masses and respiratory compromise may be diagnosed with lymphoblastic lymphoma if they have a pleural effusion. This finding suggests thoracentesis can diagnose lymphoma, avoiding risky anesthesia for biopsy.
Area of Science:
- Pediatric Oncology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Large anterior mediastinal masses in children often cause severe respiratory compromise.
- Biopsy is preferred for diagnosis but carries risks due to potential anesthesia complications.
- Pleural effusions may correlate with lymphoblastic lymphoma, offering a diagnostic alternative.
Purpose of the Study:
- To determine if pleural effusions are more frequent in pediatric lymphoblastic lymphoma than Hodgkin's disease.
- To assess if pleural effusions can aid in diagnosing anterior mediastinal masses in compromised children.
Main Methods:
- Retrospective review of 101 pediatric patients with anterior mediastinal masses (1980-1994).
- Blinded review of radiographic imaging (chest X-ray/CT) for pleural effusions in 88 cases.
- Comparison of effusion frequency between lymphoblastic lymphoma and Hodgkin's disease.
Main Results:
- Pleural effusions were present in 71% of lymphoblastic lymphoma cases versus 11.7% of Hodgkin's disease cases.
- The association between pleural effusions and lymphoblastic lymphoma was statistically significant (P < .002).
Conclusions:
- Pleural effusions are significantly more associated with lymphoblastic lymphoma than Hodgkin's disease in pediatric anterior mediastinal masses.
- Thoracentesis can be a valuable diagnostic tool, potentially avoiding anesthesia and open biopsy in high-risk patients.