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[Three cases of malignant lymphoma developing from chronic empyema wall]
1Department of Hematology, Tenri Hospital.
Summary
This study reports on three cases of non-Hodgkin's lymphoma (NHL) in patients with a history of tuberculosis. Early diagnosis of these rare pleural lymphomas is crucial for improving patient outcomes.
Area of Science:
- Oncology
- Pulmonology
- Pathology
Background:
- Non-Hodgkin's lymphoma (NHL) can rarely develop in the pleura.
- A history of tuberculous pleuritis or artificial pneumothorax may be a predisposing factor for pleural NHL.
- This study investigates three cases of NHL arising in the pleura or chest wall.
Observation:
- All three patients had a history of tuberculosis treatment decades prior.
- The NHLs developed in or near thickened pleura.
- Histology revealed diffuse large B-cell lymphoma (CD20 positive) in all cases.
Findings:
- Tumors were unresectable, treated with chemotherapy or radiotherapy.
- Two patients died within 6 months; one survived 8 months post-treatment.
- Diagnostic indicators include chest pain, elevated LDH, CT mass, and Gallium-67 uptake.
Implications:
- Early diagnosis of pleural NHL is challenging but essential for prognosis.
- Co-existent pyothorax complicates tumor assessment.
- Gallium scans and MRI are valuable for monitoring treatment response and tumor size.