Malignant lymphomas developing in tissue affected by a long-standing severe inflammatory process of nonautoimmune nature are presented. Two men and a woman aged 50, 58, and 73 years, were admitted after 22 to 30 year histories of pyothorax resulting from artificial pneumothorax for the treatment of pulmonary tuberculosis or tuberculous pleuritis. The diagnoses at admission were chronic pyothorax associated with a lung mass. Microscopically, tumors diffusely or locally proliferated with thickened pleura were present. A histologic examination showed that all the tumors were diffuse non-Hodgkin's lymphomas (NHL) of immunoblastic type with (one case) or without (two cases) plasmacytoid differentiation. Immunohistochemistry on paraffin sections revealed restricted expression of immunoglobulin light chains in one case showing plasmacytoid differentiation. A review of the literature showed that malignant lymphomas of this type have been reported exclusively from Japan but never from Western countries.

Background. Lymphomatoid granulomatosis is a very rare disease, with only 11 cases having been reported in Japan. We report different outcomes in two cases of pulmonary lymphomatoid granulomatosis. Cases. Case 1 involved a 68-year-old woman who had an abnormal pulmonary hilar shadow on chest radiography. Bronchoscopy did not assist diagnosis, so partial resection of the lung was performed under video-assisted thoracic surgery. Frozen section examination suggested lung cancer. Right middle lobectomy with dissection of the mediastinal lymph nodes was performed. Histopathology revealed grade III lymphomatoid granulomatosis. Adjuvant chemotherapy proved ineffective and the patient died 10 months postoperatively. Case 2 involved a 71-year-old woman who also had an abnormal shadow on chest radiography. Bronchoscopy again proved unhelpful, so partial resection of the lung was performed under video-assisted thoracic surgery. Frozen section examination yielded a diagnosis of lymphomatoid granulomatosis, and histopathology confirmed grade I lymphomatoid granulomatosis. The patient remains alive without any sign of recurrence at 1 year postoperatively. Conclusion. We report these 2 cases and review the reports of lymphomatoid

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A 62 year-old male patient was diagnosed as having active pulmonary tuberculosis with positive sputum culture for tuberculosis bacillus. He responded well to antituberculosis chemotherapy at first. However, exacerbation of the disease occurred 5 months later unexpectedly.