Primary Pleural Diffuse Large B-cell non-Hodgkin’s Lymphoma Diagnosed via [18F]-2-Fluoro-Deoxy-DGlucose Positron Emission Tomography /Computed Tomography

Primary pleural lymphoma is a rare entity. We report a 64-year-old-man with primary malignant lymphoma arising in the pleura with no history of persistent pyothorax. Chest computed tomography scan (CT) showed left pleural effusion with thickening of the parietal pleura. There were no intrapulmonary or mediastinal abnormalities. Analysis of pleural effusion did not detect empyema, tuberculosis, mycobacterium species, or mycelium. Initially, malignant mesothelioma was suspected, but it could not be diagnosed by cytological examination of pleural fluid. Flow cytometric analysis of pleural fluid showed cytomorphologic and immunophenotypic evidence of diffuse B cell non Hodgkin’s lymphoma (nHl) (Figure 1). [18F]2-fluoro-deoxy-D-glucose (F-18 FDg) positron emission tomography/computed tomography (PET/CT) scan revealed a diffuse F-18 FDg uptake on thickened costal and diaphragmatic parietal pleura in left hemithotax indicating pleural involvement (Figure 2).Pathological and immunohistochemical (with CEA, lCA, CD20, CD3) examination of the pleural lesion obtained by pleural biopsy revealed that it was B-cell of the diffuse large cell type of nHl arising from the pleura . We have written informed consent and no conflict of interest.