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Primary Effusion Lymphoma in an Elderly HIV-Negative Patient with Hemodialysis: Importance of Evaluation for Pleural Effusion in Patients Receiving Hemodialysis.
[primary effusion lymphoma]
Pleural
effusion
is
a
ubiquitous
complication
in
hemodialysis
(
HD
)
patients
.
Common
etiologies
of
pleural
effusion
in
this
patient
group
are
heart
failure
,
volume
overload
,
parapneumonic
effusion
,
tuberculotic
pleuritis
,
and
uremic
pleuritis
.
Although
thoracentesis
is
a
useful
diagnostic
method
of
pleural
effusion
,
empirical
reduction
of
the
dry
weight
is
often
attempted
without
thoracentesis
because
pleural
effusion
is
commonly
caused
by
volume
overload
and
responds
to
the
dry-weight
reduction
.
However
,
this
empiricism
has
a
risk
of
overlooking
or
delaying
the
diagnosis
of
potentially
fatal
etiologies
that
need
specific
treatments
.
We
report
an
86
-
year
-old
human
immunodeficiency
virus
(
HIV
)
-
negative
male
on
HD
with
primary
effusion
lymphoma
(
PEL
)
,
a
large
-cell
non-
Hodgkin
lymphoma
presenting
with
characteristic
lymphomatous
effusions
in
the
absence
of
solid
tumor
masses
,
which
is
in
association
with
human
herpes
virus
8
(
HHV
8
)
infection
in
immunocompromised
individuals
.
The
patient
presented
with
left-sided
pleural
effusion
.
This
is
the
first
case
report
of
PEL
developing
in
a
patient
receiving
HD
.
Thoracentesis
and
cytological
analysis
of
the
effusion
was
key
to
the
diagnosis
.
We
also
review
the
literature
regarding
pleural
effusion
in
HD
patients
.
Further
,
we
examine
Kaposi
's
sarcoma
herpes
virus
/
HHV
8
-
negative
effusion-based
lymphoma
,
a
newly
proposed
distinct
lymphoma
that
clinically
and
cytomorphologically
resembles
PEL
,
because
it
can
be
cured
without
chemotherapy
.
This
report
may
arouse
clinicians
'
attention
regarding
the
importance
of
evaluation
for
pleural
effusion
in
HD
patients
,
especially
when
the
effusion
or
symptoms
associated
with
pleural
effusion
are
refractory
to
volume
control
.
Diseases
Validation
Diseases presenting
"and uremic pleuritis"
symptom
primary effusion lymphoma
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