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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
"immunodeficiency"
symptom
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
cushing syndrome
dracunculiasis
hirschsprung disease
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
kabuki syndrome
legionellosis
malignant atrophic papulosis
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
primary effusion lymphoma
primary hyperoxaluria type 1
pyomyositis
severe combined immunodeficiency
sneddon syndrome
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated