Epstein-Barr virus-positive pyothorax-associated lymphoma arising from a posttraumatic empyema.
Epstein-Barr virus-positive pyothorax-associated lymphoma arising from a posttraumatic empyema.
复制标题
由外伤后脓胸引起的 Epstein-Barr 病毒阳性脓胸相关淋巴瘤。
DOI：
10.1159/000380809
复制
发表时间：
2015
影响因子：
2.4
通讯作者：
Masanori Daibata
中科院分区：
文献类型：
--
作者：
Ayuko Taniguchi;Yumiko Hashida;Yuiko Nemoto;Hisanori Machida;SungGi Chi;Takayuki Ikezoe;Akihito Yokoyama;Masanori Daibata
脓胸相关淋巴瘤 (PAL) 是由治疗肺结核或结核性胸膜炎期间产生的人工气胸引起的脓胸发展而来。我们报告了第一例由外伤后脓胸引起的 Epstein-Barr 病毒 (EBV) 阳性 PAL 病例。一名 75 岁女性，患有慢性外伤后脓胸，就诊时发现肿瘤与右胸腔脓胸壁相连。 45岁时，右胸部有外伤史，导致慢性外伤后脓胸。切除肿瘤的病理学特征对于 EBV 阳性 PAL 的诊断是决定性的。术后虽未进行化疗或放疗，但仍维持缓解3年直至肝脏复发。联合化疗使病情完全缓解，在初次诊断 PAL 9 年后，患者仍然活着。一个有趣的发现是疾病过程中的表型变化。尽管原发肿瘤的 CD20 和 CD3 呈阴性，但复发肿瘤却表达这两种分子。我们讨论这例并非肺结核并发症的 PAL 病例，以及在淋巴瘤细胞中观察到的异常时间表型变化，并将其与常见的 PAL 病例进行比较。
Pyothorax-associated lymphoma (PAL) develops from a pyothorax caused by an artificial pneumothorax created during the treatment of pulmonary tuberculosis or tuberculous pleuritis. We report the first case of Epstein-Barr virus (EBV)-positive PAL arising from a posttraumatic empyema. A 75-year-old woman with chronic posttraumatic empyema presented with a tumor, which was connected to the wall of a pyothorax in the right thoracic cavity. She had a history of trauma to the right chest, which had occurred at the age of 45 years and had caused the chronic posttraumatic empyema. Pathological features of the resected tumor were conclusive for a diagnosis of EBV-positive PAL. Although neither postoperative chemotherapy nor radiotherapy was performed, remission was maintained for 3 years until recurrence in the liver. Combination chemotherapy led to complete remission, and 9 years after the initial diagnosis of PAL, the patient is still alive. An intriguing finding is the phenotypic alteration during the disease course. Although the primary tumor was negative for CD20 and CD3, the recurrent tumor expressed both of these molecules. We discuss this case of PAL, which was not a complication of lung tuberculosis, and the aberrant chronological phenotypic change observed in the lymphoma cells, and compare it with a usual case of PAL.