CASE REPORT article
Front. Med.
Sec. Pulmonary Medicine
This article is part of the Research TopicThe Novel Insight into Managements of Undiagnosed Pleural EffusionView all 6 articles
Rare Pleural Effusion: A rare case of B-lymphoblastic Lymphoma with pleural effusion and Discussion of Diagnostic Challenges
Provisionally accepted
- 1Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China
- 2Pathology Department, Tianjin Chest Hospital, Tianjin, China
- 3Affiliated Chest Hospital of Tianjin University,Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China
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ABSTRACT Background: Lymphoblastic lymphoma is a rare type of malignant lymphoma. B-lymphoblastic lymphoma with pleural effusion as the initial manifestation is extremely rare, here we report the specific and challenging diagnostic process. Case presentation: We present a case of 67-year-old woman who was initially diagnosed tuberculous pleurisy with right pleural effusion. The pleural effusion was an exudate mainly composed of mononuclear cells with elevated adenosine deaminase (ADA) and lactate dehydrogenase (LDH). The cytological result of pleural effusion was negative. The contrast-enhanced CT suggested right pleural nodules with partial pleural thickening. Then, CT-guided percutaneous needle pleural biopsy was performed, pathological consultation, bone marrow biopsy and flow cytology examination were carried out. Finally, B-lymphoblastic lymphoma was diagnosed. Currently, she is improved after chemotherapy without pleural effusion. Conclusion: Malignant pleural effusion caused by lymphoma is easily confused with tuberculous pleurisy. Usually, the elevation of ADA and LDH is more obvious. Flow cytology examination of pleural fluid can be considered, and histological specimens should be actively obtained to clarify the pathological diagnosis. For patients with extensive pleural thickening, CT-guided percutaneous pleural biopsy can be preferentially selected.
Keywords: B-lymphoblastic lymphoma, Pleural Effusion, Tuberculous pleurisy, Adenosine Deaminase, CT-guided percutaneous pleural biopsy
Received: 28 Apr 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Lu, Zong, Yang, Zhang, Jia and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi Li, lisalie5252@hotmail.com
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