Spinal epidural involvement in pleural lymphomas developing from long-standing tuberculous pyothorax or pleuritis

Area of Science:

• Oncology
• Neurology
• Pathology

Background:

• Pleural lymphoma can arise from long-standing pyothorax or pleuritis.
• Chronic tuberculous pyothorax has been previously associated with pleural lymphomas.
• Spinal epidural involvement is an uncommon but serious complication.

Observation:

• Three patients with pleural lymphoma secondary to chronic pyothorax presented with spinal epidural involvement.
• Two patients exhibited symptoms of cord compression syndrome alongside pleural tumors.
• One patient developed rapid cord compression signs eight months post-pleural lymphoma diagnosis.

Findings:

• Biopsy and autopsy confirmed malignant lymphoma in both pleural tumors and epidural masses.
• This study reports the first association between spinal epidural compression and pyothorax-related pleural lymphoma.
• The pathological features of the pleural and epidural lymphomas were consistent.

Implications:

• Spinal epidural involvement should be considered a significant potential complication in patients with pyothorax-related pleural lymphoma.
• Early recognition and management of spinal epidural compression are crucial for patient outcomes.
• This finding expands the understanding of lymphoma's metastatic potential in the context of chronic thoracic infections.