Intrathoracic Manifestations of Hematologic Malignancies: A Narrative Review

Authors

• Kshama Bhyravabhotla
• Gregory Gaskey
• Jeremy R Walder
• Diwakar D Balachandran
• Sujith V Cherian
• Bilal Zafar
• Lara Bashoura
• Ajay Sheshadri
• Saadia A Faiz

Language

English

Publication Date

12-31-2025

Journal

Annals of Translational Medicine

DOI

10.21037/atm-25-139

PMID

41502434

PMCID

PMC12771058

PubMedCentral® Posted Date

12-24-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background and objective: Although the global incidence of hematologic malignancies is decreasing, the risk of developing these cancers is increasing due to increased lifespan and modern treatments including targeted therapy, chemotherapy, and radiation. Intrathoracic manifestations of hematologic malignancies may be the presenting sign leading to diagnosis or result from various treatment toxicity. The most common respiratory manifestation of hematologic malignancies is infectious, but up to half of pulmonary findings are from non-infectious etiologies. We aim to summarize the current literature on non-infectious intrathoracic manifestations of hematologic malignancies and their treatment.

Methods: We performed a literature review using PubMed Central and Google Scholar for articles published between January 1st, 2014, and January 1st, 2024. We used medical subject heading terms to search titles, abstracts, and diagnoses. We reviewed textbook chapters, literature reviews, practice guidelines, randomized controlled trials, and retrospective articles.

Key content and findings: There are many pulmonary manifestations of hematologic malignancies. Lymphadenopathy and disease of serosal membranes are common. Pleural effusions can be malignant or related to treatment, and interventions include serial thoracentesis or indwelling pleural catheters (IPCs). Parenchymal diseases consist of primary pulmonary lymphoma, leukemic pulmonary infiltration, myeloid sarcoma, pulmonary alveolar proteinosis, and leukemic cell lysis pneumopathy. Endobronchial disease is rare. Pulmonary vascular disorders involve leukostasis, thromboembolic disease, pulmonary hypertension (PH), superior vena cava (SVC) syndrome, and pseudohypoxemia. Therapy-related sequelae may also occur.

Conclusions: Intrathoracic manifestations of hematologic malignancies should be considered in the differential diagnosis at the time of presentation since their management differs substantively.

Keywords

Hematologic malignancy, pulmonary, malignant pleural effusion (MPE), lymphoma, leukemia

Published Open-Access

yes

Recommended Citation

Bhyravabhotla, Kshama; Gaskey, Gregory; Walder, Jeremy R; et al., "Intrathoracic Manifestations of Hematologic Malignancies: A Narrative Review" (2025). Faculty, Staff and Student Publications. 3576.
https://digitalcommons.library.tmc.edu/uthmed_docs/3576