Malignant Lymphoma Developing from Chronic Empyema Wall.

Abstract

A 74-year-old male, who had been treated with artificial pneumothorax for pulmonary tuberculosis 38 years before, was admitted with fever on May 1992. Chest X-ray revealed the presence of scarred empyema in the right thorax, whereas the abdominal computed tomography indicated the presence of tumor extending from the pleural wall to the liver. The aspirated pleural effusion was suggestive of malignant lymphoma. He died in september 1992. Autopsy revealed non-Hodgkin's malignant lymphoma of pleural origin involving lower half of right pleura, right diaphragm and right upper abdominal cavity including the right lobe of the liver. Histologically was diffuse large cell type non-Hodgkin's lymphoma according to the LSG classification, showing B cell phenotype on immunohistologic studies. In addition, Epstein-Barr virus (EBV) genome, EBERs, EBNA2 (strong) and LMP (weak) proteins were detected by PCR, in situ hybridization and immunology, respectively, indicating the association of EBV with lymphomagenesis in this case.