Diffuse Large B-cell Lymphoma Complicated with Tuberculous Pleurisy Diagnosed by Medical Thoracoscopy

Main Article Content

Yuri Baba Yugo Kaneko Ikumi Fujisaki Hironori Kawamoto Hirofumi Yamauchi Kai Ryu Nayuta Saito Sho Watanabe Tsugumi Horikiri Aya Seki Akira Kinoshita Hiroshi Takeda Keisuke Saito Kzuyoshi Kuwano Yutaka Yoshii

Abstract

An 80-year-old man was admitted withright pleural effusion and bilateral axillary lymph node enlargement. Histopathological examination of the axillary lymph node biopsy specimen showed diffuse large B-cell lymphoma (DLBCL). The pleural effusion was exudative and predominantly lymphocytic, and cytology of the effusion was compatible with malignant lymphoma. Although acid-fast bacillus smear and polymerase chain reaction analysis of the pleural effusion were negative, pleural adenosine deaminase (P-ADA) was high (79.2 IU/L). We suspected tuberculous pleurisy and performed thoracoscopy. We diagnosed DLBCL with tuberculous pleurisy and started tuberculosis treatment. When P-ADA is high, thoracoscopy should be performed to explore tuberculous pleurisy.

Article Details

How to Cite
BABA, Yuri et al. Diffuse Large B-cell Lymphoma Complicated with Tuberculous Pleurisy Diagnosed by Medical Thoracoscopy. Medical Research Archives, [S.l.], v. 5, n. 6, june 2017. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1176>. Date accessed: 19 june 2024.
Keywords
diffuse large B-cell lymphoma,tuberculous pleurisy,adenosine deaminase, thoracoscopy
Section
Case Reports

References

1. Okuda M, Tanaka N, Kashio M, et al. Rapid improvement of massive bloody pleural
effusion after splenectomy for splenic marginal zone lymphoma. BMJ case reports 2009: bcr0920080974, 2009.
2. Kato F, Hirasawa Y, Iioka Y, et al. [A case of primary effusion lymphoma with
elevation of ADA activity in pleural effusion]. Nihon Kokyuki Gakkai zasshi = the
journal of the Japanese Respiratory Society 49: 786-791, 2011.
3. Bachuwa G, Naik P, Campe J, Lecea N, Congdon D. Ninety-one year old: oldest
patient reported with pulmonary mucosa-associated lymphoid tissue lymphoma and
rare association with pleural effusion. Geriatrics & gerontology international 12:
149-151, 2012.
4. Sekiguchi N, Noto S, Wagatsuma M, et al. Extramedullary hematopoietic pleural
effusion accompanied by follicular lymphoma. Internal medicine 52: 2801-2804,
2013.
5. Ungerer JP, Grobler SM. Molecular forms of adenosine deaminase in pleural
effusions. Enzyme 40: 7-13, 1988.
6. Ocana I, Martinez-Vazquez JM, Ribera E, Segura RM, Pascual C. Adenosine
deaminase activity in the diagnosis of lymphocytic pleural effusions of tuberculous, neoplastic and lymphomatous origin. Tubercle 67: 141-145, 1986.
7. Mito A, Ohashi N, Akita S, et al. [A case of natural killer cell lymphoma with high
adenosine deaminase level in pleural effusion]. Nihon Kokyuki Gakkai zasshi = the
journal of the Japanese Respiratory Society 43: 360-364, 2005.
8. Anai S, Hashisako M, Ikegame S, et al. Mantle cell lymphoma involvement of the
pleura and tuberculous pleurisy with pulmonary tuberculosis: a case report and
literature review. Journal of infection and chemotherapy : official journal of the
Japan Society of Chemotherapy 18: 258-264, 2012.
9. Epstein DM, Kline LR, Albelda SM, Miller WT. Tuberculous pleural effusions. Chest
91: 106-109, 1987.
10. Valdes L, Alvarez D, San Jose E, et al. Tuberculous pleurisy: a study of 254 patients.
Archives of internal medicine 158: 2017-2021, 1998.
11. De Oliveira HG, Rossatto ER, Prolla JC. Pleural fluid adenosine deaminase and
lymphocyte proportion: clinical usefulness in the diagnosis of tuberculosis.
Cytopathology : official journal of the British Society for Clinical Cytology 5: 27-
32, 1994.
12. Perez-Rodriguez E, Perez Walton IJ, Sanchez Hernandez JJ, et al. ADA1/ADAp
ratio
in pleural tuberculosis: an excellent diagnostic parameter in pleural fluid.
Respiratory medicine 93: 816-821, 1999.
13. Lima DM, Colares JK, da Fonseca BA. Combined use of the polymerase chain
reaction and detection of adenosine deaminase activity on pleural fluid improves
the rate of diagnosis of pleural tuberculosis. Chest 124: 909-914, 2003.
14. Tahhan M, Ugurman F, Gozu A, Akkalyoncu B, Samurkasoglu B. Tumour necrosis
factor-alpha in comparison to adenosine deaminase in tuberculous pleuritis.
Respiration; international review of thoracic diseases 70: 270-274, 2003.
15. Buyukberber M, Sevinc A, Cagliyan CE, Gulsen MT, Sari I, Camci C. Non-Hodgkin lymphoma with high adenosine deaminase levels mimicking peritoneal tuberculosis: an unusual presentation. Leukemia & lymphoma 47: 565-568, 2006.
16. Yao CW, Wu BR, Huang KY, Chen HJ. Adenosine deaminase activity in pleural
effusions of lymphoma patients. QJM : monthly journal of the Association of
Physicians 107: 887-893, 2014.