Lymph > BCBL

Primary effusion lymphoma-Body Cavity-based Lymphoma:


Non-Hodgkins lymphomas that manifest solely in the serous body cavities in the absence of identifiable tumor masses are defined as primary effusion lymphoma (PEL) or body cavity-based lymphoma (BCBL). BCBL has an association with human herpes virus 8 (HHV-8) and it is found preferentially, though not exclusively, in association with HIV infection. It accounts for about 3-4% of all HIV-associated non-Hodgkin lymphomas and is often associated with a concomitant diagnosis of Kaposi sarcoma [3,4]. Patients present with fever, cough, chest pain, and dyspnea. Typically there is widespread serosal involvement that results in pleural and pericardial effusions and ascites (the pericardial and peritoneal spaces can also be involved [4]).

Pleural lymphoma (pyothorax-associated lymphoma) can also occur as a result of chronic inflammatory pyothorax, usually secondary to iatrogenic pneumothorax for treatment of tuberculosis [4]. It is a rare Epstein-Barr positive diffuse large B-cell lymphoma that typically manifests as a solid pleural mass that may extend directly into the lung and can be associated with a pleural effusion [4].


Unilateral (or bilateral), homogeneous, near-water attenuation pleural effusion not associated with parenchymal opacities or adenopathy is typically seen [4]. Slight thickening of the parietal pleura may be evident on CT, and pericardial and abdominal fluid collections can also be seen.


(1) Radiology 1997; Morassut S, et al. HIV-associated human herpesvirus 8- positive primary lymphomatous effusions: Radiologic findings in six patients. 205: 459-463

(2) AJR 2007; Burns J, et al. Oncogenic viruses in AIDS: mechanisms of disease and intrathoracic manifestations. 189: 1082-1087

(3) Radiographics 2012; Jeudy J, et al. Cardiac lymphoma: radiologic-pathologic correlation. 32: 1369-1380

(4) Radiographics 2017; Bligh MP, et al. Spectrum of CT findings in thoracic extranodal non-hodgkin lymphoma. 37: 439-461

(5) Radiographics 2018; Javadi S, et al. HIV-related malignancies and mimics: imaging findings and management. 38: 2051-2068

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