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Pyothorax-associated large B-cell lymphoma: case report with emphasis on the potential diagnostic challenge.
1Department of Pathology, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Hong Kong.
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|October 12, 2002
Summary
A rare pyothorax-associated large B-cell lymphoma case in Hong Kong involved a 64-year-old male. This lymphoma showed co-infection with Epstein-Barr virus and human herpesvirus type 8.
Area of Science:
- Oncology
- Virology
- Pathology
Background:
- Pyothorax-associated large B-cell lymphoma (PTA-LBCL) is a rare extranodal non-Hodgkin lymphoma.
- It typically arises in patients with a history of chronic empyema, often associated with tuberculosis.
Observation:
- A 64-year-old Chinese male presented with dyspnea and pleuritic chest pain.
- Radiological findings included left pleural thickening and bilateral pleural effusions.
- Histopathology of pleural biopsy revealed large malignant lymphoid cells of B lineage.
Findings:
- In situ hybridization and immunohistochemistry confirmed the lymphoma cells harbored Epstein-Barr virus (EBV) and human herpesvirus type 8 (HHV-8).
- The patient had no lymphadenopathy or hepatosplenomegaly, consistent with PTA-LBCL criteria.
- This case highlights the diagnostic challenges and unique features of PTA-LBCL.
Implications:
- The co-infection with EBV and HHV-8 suggests a potential pathogenetic link between PTA-LBCL and primary effusion lymphoma (PEL).
- Increased awareness and utilization of ancillary techniques like in situ hybridization are crucial for accurate diagnosis of this rare entity.
- Further research into the viral etiology of PTA-LBCL may elucidate its pathogenesis and inform therapeutic strategies.