[Clinical analysis of eight cases with pyothorax-associated lymphoma]

We retrospectively reviewed the medical records of eight patients (five males and three females, median age: 75.6) with pyothorax-associated lymphoma (PAL) from 1993 to 2007. All cases were histopathologically identified as diffuse large-B-cell lymphoma and had a history of artificial pneumothorax for the treatment of pulmonary tuberculosis. Chest and/or dorsal pain was the most common symptom followed by bloody sputum. Ten needle biopsies and five surgical biopsies were performed, and diagnostic rates were 30% and 60% respectively. More than two biopsies were needed in four out of eight patients. Nine months in median were necessary to confirm a diagnosis of PAL. We evaluated gallium scintigraphy in five and 18FDG-PET in two patients. High uptake was observed only at the tumor site, not in the pleural cavities of all examined patients. While all five male patients died of their tumors, the three female patients were all alive after intensive therapy. We conclude that gallium scintigraphy, and 18FDG-PET are useful for discriminating tumor from pyothorax. It is also necessary to further understand the uncertainty of biopsy results and the need for repeat examinations for early diagnosis of PAL.