[Prognosis of the surgical treatment for non-Hodgkin lymphoma originating from chronic tuberculous empyema--analysis of 11 cases with pleuropneumonectomy].
In total 19 cases of non-Hodgkin lymphoma originating from the wall of chronic tuberculous empyema, pleuropneumonectomeic were performed since 1979, with the aim of total cures for not only lymphoma but empyema in 11 cases. Of these cases extraresections (5 of thoracic cages, 4 of diaphragms, 2 of axillar lymph nodes, each of adventitia of descending aorta and esophagus, of the liver, of the left adrenal grand) were added to extirpate tumors completely. The mean operating time was 6 degrees 55', the mean blood loss during operations was 3090 ml, but in the 3 most recent cases it was less than under 1000 ml using electrocartesy-cutting technique under direct observation. Although preoperative radiations were done to 4 cases to decrease invasive area of tumors and postoperative radiation was done to 1 case, there were no adjuvant chemotherapies. The indicative limitation for resections from the point of ventilatory functions was the same as that of pleuropneumonectomy for ordinary chronic tuberculous empyema. There were 2 cases with serious postoperative complications. One suffered from ARDS and died on the 14th postoperative day, and another developed acute respiratory failure and MOF. But the other 9 cases kept good postoperative courses with a few recurrences of minor empyema. The prognoses for 10 remaining cases is excellent. Only one case died from local recurrence in of lymphoma 27 months later, but all other 9 cases have revealed no recurrence in any places, and the 5 year survival rate based on Kaplan-Meier method of 10 cases is 85.7%. By the way no cases could survive one year later in unresected group. So under the poor prognosis of treatment with radiation or chemotherapy for non-Hodgkin lymphoma originating from chronic tuberculous empyema, we conclude that the complete resection of tumor and empyema, so called pleuropneumonectomy, is the best way to cure this disease.
Nakajima
Y
Y
Department of Thoracic Surgery, Fukujuji Hospital, Japan.
Waku
M
M
Kojima
A
A
Sato
Y
Y
Miyanaga
S
S
D000368:Aged; D002908:Chronic Disease; D004654:Empyema, Tuberculous / Q000150:complications*; D006801:Humans; D008197:Lymph Node Excision; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000601:surgery*; D010997:Pleural Neoplasms / Q000209:etiology / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis