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(Chest. 2004;125:1546-1555.)
© 2004 American College of Chest Physicians

Pleural Effusions in Hematologic Malignancies*

Michael G. Alexandrakis, MD; Freda H. Passam, MD; Despina S. Kyriakou, MD and Demosthenes Bouros, MD, FCCP

* From the Department of Hematology (Dr. Alexandrakis), University Hospital of Heraklion, and Medical School, University of Crete, Crete; Hematology Unit (Dr. Passam), Third Department of Medicine, Sotiria Hospital, Medical School, University of Athens, Athens; Department of Hematology (Dr. Kyriakou), University Hospital of Larisa, and Medical School of Thessaly, Thessaly; and Department of Pneumonology (Dr. Bouros), University Hospital of Alexandroupolis, and Medical School, University of Thrace, Thrace, Greece.

Correspondence to: Demosthenes Bouros, MD, FCCP, Department of Pneumonology, Medical School, University of Thrace and University Hospital, 1A Achilleos St, Athens 15342, Greece; e-mail: bouros{at}med.duth.gr

Nearly all hematologic malignancies can occasionally present with or develop pleural effusions during the clinical course of disease. Among the most common disorders are Hodgkin and non-Hodgkin lymphomas, with a frequency of 20 to 30%, especially if mediastinal involvement is present. Acute and chronic leukemias, myelodysplastic syndromes, are rarely accompanied by pleural involvement. Furthermore, 10 to 30% of patients receiving bone marrow transplantation develop pleural effusions. In cases of hematologic pleural effusions, drug toxicity, underlying infectious, secondary malignant or rarely autoimmune causes should be carefully sought. In most cases, the pleural fluid responds to treatment of the primary disease, whereas resistant or relapsing cases may necessitate pleurodesis.

Key Words: leukemia • lymphoma • pleural fluid • pleural infiltration




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