A surgical case of pyothorax-associated lymphoma

Abstract

A 65-year-old man was admitted complaining of a painful swelling on the left side of the chest wall, fever and cough. Chest CT scan demonstrated a tumor, 30×40mm in size, adjacent to the calcified parietal pleura of long-standing pyothorax. Examination of a specimen obtained by percutaneus needle biopsy resulted in a diagnosis of malignant lymphoma, diffuse large B cell type. Tumor resection and removal of the entire pyothorax was performed on March 22, 2001 under the diagnosis of pyothorax-associated lymphoma (PAL). The lung was preserved. A resected specimen histologically confirmed the above diagnosis . EBV genomes in Southern blot of the tumor demonstrated oligoclonal proliferation. EBV-encoded small RNAs (EBERs) was positive in EBV- in situ hibridization. EBV-LMP1 (Epstein-Barr virus latent membrane protein 1) and EBNA2 (Epstein-Barr virus nuclear antigen 2) were negative.After CHOP therapy, he has been well for 10 months without any signs of recurrence.