Pyothorax-associated T-cell Lymphoma: a Case Report

• Published in: Japanese journal of clinical oncology 2003-03, Vol.33 (3), p.145-147
• Main Authors: Hashizume, Toshihiko, Aozasa, Katsuyuki, Tomita, Yasuhiko, Matsushita, Kazuhiko
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Empyema, Pleural - etiology; Empyema, Pleural - pathology; Genome, Viral; Herpesvirus 4, Human - genetics; Humans; Immunophenotyping; Key words: pyothorax-associated lymphoma – peripheral T-cell lymphoma – malignant lymphoma – Epstein–Barr virus; Lymphoma, T-Cell, Peripheral - complications; Lymphoma, T-Cell, Peripheral - pathology; Lymphoma, T-Cell, Peripheral - radiotherapy; Male
• ISSN: 0368-2811; 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyg024

We present a case of pyothorax-associated T-cell lymphoma in which Epstein–Barr virus (EBV) genome is not detected in the tumor cells. An 80-year-old male came to our hospital because of a left chest pain. Chest computed tomography (CT) showed a mass at the lower-dorsal part of the pyothorax wall, which involved the adjacent chest wall. The surgical biopsy specimen showed a predominant infiltration of atypical lymphocytes. Results of immunohistochemical analysis were as follows: CD3+, CD4–, CD8+, CD20–, CD30–, CD45RO+ and CD79a–. We diagnosed this case as a type of peripheral T-cell lymphoma. In situ hybridization using EBV-encoded RNA-1 (EBER-1) did not reveal the positive signals in the nucleus of tumor cells. Polymerase chain reaction (PCR) analysis yielded a negative result for human herpesvirus 8 (HHV8). Radiation therapy at 54 Gy reduced the tumor size by 90%. Visual and hearing disturbances of unknown etiology developed just before the completion of radiotherapy. The symptoms progressively worsened and the patient became bedridden. He died of pneumonia 2 months after the completion of radiotherapy. Autopsy did not reveal abnormalities to which the neurological disturbances were attributable.