2010 Volume 50 Issue 4 Pages 371-376
Background. We report an extremely rare case of extranodal marginal zone lymphoma (EMZL) which developed in the chest wall. Case. A 62-year-old man was receiving treatment for left thigh cellulitis in hospital, underwent regular measurement of his serum D-dimer level. Because of an elevated level, chest CT was performed to locate a suspected pulmonary thromboembolism. However chest CT disclosed a solitary tumor, 15 mm in maximum dimension in the right chest wall, and a solitary liver tumor, but not a pulmonary thromboembolism. A percutaneous needle biopsy of the liver tumor excluded the possibility of a malignant tumor, but did not yield a definite diagnosis either. Magnetic resonance imaging (MRI) showed that the tumors of the liver and the chest wall had similar characteristics, especially according to a dynamic study. We observed the course of this case carefully. At a 1-year follow-up examination, since the chest wall tumor had increased in size, it was resected with video-assisted thoracoscopic surgery (VATS). Histological and immunohistochemical examinations revealed the chest wall tumor to be an EMZL. The similar characteristics on MRI studies, and the histological findings of both tumors suggested that their origin might be identical. Conclusions. We report an extremely rare case of EMZL which developed from the chest wall. MRI was necessary to identify the origin of the multiple organ lesions.
