EBV‐associated diffuse large B‐cell lymphoma arising in the chest wall with surgical mesh implant

Abstract

In Japan, most cases of malignant lymphoma arising in the thorax are pyothorax-associated lymphoma, which develops in patients who have undergone artificial pneumothorax, used in the past as surgical therapy for pulmonary tuberculosis. Pyothorax-associated lymphoma consist mostly of diffuse large B-cell lymphoma and have a strong association with EBV. Herein is reported the case of a diffuse large B-cell lymphoma arising in the left thoracic wall after left lung resection for squamous cell carcinoma and chest wall reconstruction with polyethylene terephthalate (PET) surgical mesh. The tumor was found 20 years after the operation and was confined to the chest wall adjacent to the PET mesh. The patient did not have a clinical history of pyothorax after surgery. The lymphoma cells were of the large cell type and were positive for CD20, EBV-encoded small RNA--in situ hybridization, LMP-1 and EBNA-2. The present case demonstrates that EBV-related B-cell lymphoma can occur after surgery other than artificial pneumothorax. In the present case, long-standing chronic inflammation induced by PET mesh may have been associated with the development of lymphoma.

Epstein‐Barr virus‐positive diffuse large B‐cell primary central nervous system lymphoma associated with organized chronic subdural hematoma: A case report and review of the literature

“…They also mentioned that chronic inflammation might not be essential for the pathogenesis of DLBCL detected within pseudocysts . The clinical scenarios of these two cases differed considerably compared with those of reported cases categorized as DLBCL‐CI, which included prosthetic cardiac valves, metallic implants, and surgical mesh implants among others . They speculated that the closed space within which these DLBCLs arise is adequate to wall off a cytotoxic T‐cell response from the neoplasms, resulting in local immunodeficiency .…”

Diffuse large B-cell lymphoma associated with chronic inflammation as an incidental finding and new clinical scenarios

“…8,9 Lymphomas with similar features are also recognized to develop in other chronic inflammatory conditions, such as use of metallic implants in bones and joints, 10 chronic osteomyelitis, 11 chronic venous ulcer, 11 and use of surgical mesh implant. 12 In 2008, the World Health Organization classification of tumors of hematopoietic and lymphoid tissues has adopted 'DLBCL associated with chronic inflammation' as a distinct entity and unifying concept for this group of lymphomas. 13 We report four cases discovered incidentally in long-standing pathologic lesions, which contrast with the presence of frank tumor masses in the typical cases of DLBCL associated with chronic inflammation.…”

Primary diffuse large B-cell lymphoma of the chest wall: a case report

“…Fujimoto et al [18] reported the case of a patient with EBV-associated DLBCL that developed in the chest wall after a polyethylene terephthalate surgical mesh was implanted during surgery for a squamous cell lung carcinoma. In that case, the patient’s disease resembled a typical PAL in many aspects such as the location, immunostaining pattern, and the latent III form of EBV infection.…”