Non-Hodgkin's lymphoma of the pleural cavity developing from long-standing pyothorax

Abstract

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.

Epstein-Barr virus–associated lymphoproliferative disorders

“…Pyothorax-associated lymphoma is an entity that was first described in Japanese patients by Iuchi et al in 1987 [64] and was later incorporated into the WHO classification of lung and pleural tumors in 2004 [65]. Pyothorax-associated lymphoma is considered to be a subcategory of diffuse large B-cell lymphoma that typically exhibits immunoblastic morphology, tends to present as a pleural mass, and results from long-standing pyothorax from pulmonary tuberculosis [65,66].…”

Appearance of a different clone of Epstein–Barr virus genome in recurrent tumor of pyothorax-associated lymphoma (PAL) and a mini-review of PAL

“…1,2 Thus, the term pyothorax-associated lymphoma (PAL) has been proposed for these tumors. Most PALs are diffuse large cell lymphomas (DLCL) of B cell type, 1,2 contain Epstein-Barr virus (EBV) DNA, 3,4 and express some EBV latent infection genes, EBV nuclear antigen 2 (EBNA2) and latent membrane protein 1 (LMP1).…”

Induction of Chromosomal Aberrations and Growth-Transformation of Lymphoblastoid Cell Lines by Inhibition of Reactive Oxygen Species-Induced Apoptosis with Interleukin-6

“…F rom the pathoepidemiological studies on the two types of malignant lymphoma, including B-cell lymphoma of the thyroid gland developing in patients with Hashimoto's thyroiditis (Kato et al, 1985) and B-cell lymphoma in chronic pyothorax patients (pyothorax-associated lymphoma [PAL]) (Iuchi et al, 1987(Iuchi et al, 1989, we proposed the concept of malignant lymphoma developing in chronic inflammation (Aozasa, 1992;Iuchi et al, 1989). Malignant lymphoma of mucosa-associated lymphoid tissue is also included in this category (Aozasa, 1992) because Helicobacter pylori-induced follicular gastritis predisposes to gastric lymphoma (Parsonnet et al, 1994).…”

“…Malignant lymphoma of mucosa-associated lymphoid tissue is also included in this category (Aozasa, 1992) because Helicobacter pylori-induced follicular gastritis predisposes to gastric lymphoma (Parsonnet et al, 1994). These lymphomas are exclusively of extranodal origin and B-cell nature (Iuchi et al, 1987;Kato et al, 1985;Parsonnet et al, 1994). Greiner et al (1997) suggest that stimulatory signals in B-cell differentiation, such as CD40 signaling in combination with interleukin-4 (IL-4), are involved in the development of malignant lymphoma of mucosa-associated lymphoid tissue.…”