High incidence of pericardial effusion in non-Hodgkin's lymphoma: usefulness of echocardiography.

In a consecutive group of patients with non-Hodgkin's lymphoma a prospective study was designed to detect pericardial and myocardial abnormalities at presentation for initial clinical staging. Thirty-two patients, ranging from 15 to 65 (mean, 46) years of age, were studied. Twenty-six (81%) were in Stages III and IV. Echocardiographic examination revealed that 17 patients (53%) had pericardial effusion (PE). Four subjects with lymphoblastic lymphoma and extensive mediastinal involvement had clinical and echographic signs of cardiac-tamponade. In 5 cases, pericardiocentesis was performed; abnormal lymphoblasts were demonstrated in 4. In one of these, the histological diagnosis of lymphoma was performed from analysis of the PE. The follow-up ranged from 3 to 32 (mean, 12.3) months. There was no difference in the survival rates whether or not PE was present: 70 and 68% respectively at 1 yr. No patient required intracavitary chemotherapy or surgery. We conclude that PE in advanced non-Hodgkin's lymphoma with large mediastinal masses is frequent. Once tamponade is treated, the presence of PE has no adverse effect on survival at 1 yr.