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[Pyothorax associated lymphoma treated by chemotherapy after thoracostomy]
1Second Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
Summary
This case study highlights a rare instance of non-Hodgkin's lymphoma associated with pyothorax. Open window thoracostomy proved effective for managing the pyothorax during chemotherapy for this challenging lymphoma case.
Area of Science:
- Thoracic Surgery
- Oncology
- Infectious Diseases
Background:
- Pyothorax, a rare complication, can present with challenging infections.
- Non-Hodgkin's lymphoma (NHL) can rarely be associated with chronic thoracic infections.
- Management of concurrent pyothorax and lymphoma requires multidisciplinary approaches.
Observation:
- A 62-year-old male with a history of artificial pneumothorax developed persistent cough, atelectasis, and infected pyothorax.
- Imaging revealed pyothorax with calcifications; subsequent biopsy diagnosed diffuse large B-cell lymphoma.
- Standard treatments failed, necessitating an open window thoracostomy.
Findings:
- Open window thoracostomy facilitated management of the infected pyothorax cavity.
- Combination chemotherapy (CHOP and DeVIC) was administered with the thoracic window open.
- Despite treatment, the patient succumbed to disseminated intravascular coagulation 17 months post-thoracostomy.
Implications:
- Open window thoracostomy is a viable strategy for managing pyothorax in patients undergoing chemotherapy for lymphoma.
- Persistent pyothorax infection poses significant challenges to chemotherapy administration in lymphoma patients.
- This case underscores the complexity of treating rare pyothorax-associated lymphomas.