CD20-Negative Pyothorax-Associated B Cell Lymphoma

Fukuno, Kenji; Tsurumi, Hisashi; Kanemura, Nobuhiro; Nishio, Masaru; Tanabashi, Shinobu; Okamoto, Kiyonao; Moriwaki, Hisataka

doi:10.1159/000083453

Cited by 4 publications

(1 citation statement)

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“…There have also been other case reports of CD20-negative PAL. Kenji Fukuno et al [10] proposed that PAL probably originates from B cells, CD20 is then lost during B cell differentiation into plasma cells. Therefore some CD20-negative pyothorax-associated B cell lymphomas are expected.…”

Section: Discussionmentioning

confidence: 99%

Pyothorax-associated Lymphoma: a Case Report and Review

Dong

Su-fen

et al. 2020

Preprint

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Background: Pyothorax-associated lymphoma is a rare disease with variations in endemic prevalence. PAL arising from a posttraumatic empyema are a rare occurrence.Case presentation: a male patient, 83 years old. Twenty years earlier, the patient fell from a height, sustaining a fracture to the right rib, which improved after conservative treatment. In September 2018, the patient had right chest pain (ribs 9–10). In February 2019, the chest pain became worse during sleep. CT examination showed inflammation of the right lower lobe, chronic empyema on the right with subdiaphragmatic infection, fibrosis of the right lung, atherosclerosis, thickening of the left pleura with rib destruction, and membranous calcification around the lesion. After 5 days of treatment with cefoperazone, sulbactam sodium, and ornidazole, the patient’s chest pain did not improve. The results of 18F-FDG PET/CT showed the following: a solid mass in the lower right thoracic cavity. Immunohistochemistry showed that the tumor cells were negative for CD20 and CD3, positive for background mature T lymphocytes, positive for Pax-5, positive for MUM-1, Ki-67 (70%, +); AE1/AE3, CD138, Bcl-6, CD10, CD5, CD56, MPO (-); CD79α (part +), EMA (part +), CD38 (+), bcl-2 (+). In situ hybridization (CISH): EBER+. Mini-CHOP chemotherapy was implemented on April 11, 2019. The patient stopped taking analgesics on the day of chemotherapy. The pain disappeared one week later, and the EBV-DNA fell to the normal range. In the later stage, the family members of the patient declined further patient treatment and reexamination. The patient’s condition worsened in July 2019 and he died on September 25, 2019.Conclusion: Pathological morphology is vital important to make a final diagnosis and avoid misdiagnosis or miss diagnosis. This case is described by a combination of imaging and pathological examinations that reports the clinical pathological diagnosis and treatment process of a single case of pyothorax-associated lymphoma, and it provides some diagnostic information regarding the rare disease of PAL.

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Section: Discussionmentioning

confidence: 99%