A Case of Chronic Tuberculous Pyothorax-associated Malignant Lymphoma and the Causal Relation of Epstein-Barr Virus.

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A 69-year-old man was referred to our institution for examination and treatment of right-sided chest pain, swelling of the right chest wall and shortness of breath on exertion. He had a past history of artificial pneumothorax due to pulmonary tuberculosis at the age of 27.<BR>The computed tomography image of the chest showed a tumor mass with prominent necrosis at the mediastinal site of chronic tuberculous pyothorax. There was a similar lesion in the right chest wall. Biopsy specimen of the subcutaneous mass in the right chest wall yielded a definitive diagnosis of non-Hodgkin's lymphoma (diffuse large cell, B-cell type).<BR>We detected Epstein-Barr virus (EBV) gene products in malignant lymphoma cells. EBV-encoded nuclear antigen 2 (EBNA2) and latent membrane protein 1 (LMP1) were not detected by immunocytochemistry but EBV-encoded small RNA1 (EBER1) was detected on lymphoma cells by in situ hybridization.<BR>We therefore suggest that there can be the causal relation between EBV and pyothorax-associated malignant lymphoma.
特定非営利活動法人日本肺癌学会の論文