Pyothorax-associated lymphoma (PAL): a western case with marked angiocentricity and review of the literature.
OBJECTIVE
To report a case of pyothorax-associated lymphoma in a non-immunocompromised 78-year-old man with a 45-year history of tuberculous pleuritis and left pleural effusion. Pyothorax-associated lymphoma is a high-grade non-Hodgkin's lymphoma occurring in 2% of patients with long-standing tuberculous pleuritis and pyothorax. Pyothorax-associated lymphoma is frequently Epstein-Barr virus (EBV)-associated, mainly reported in Japan but exceedingly rare in western countries.


RESULTS
Histology revealed a high-grade, diffuse large B-cell lymphoma with immunoblastic and plasmacytoid features and marked angiocentricity with focal destruction of the vessel walls. Immunohistochemistry revealed a post germinal B-cell phenotype. RNA in-situ hybridization and molecular analysis showed a latent EBV infection and absence of human herpes virus-8 (HHV-8).


CONCLUSIONS
Pyothorax-associated lymphoma represents a rare but distinctive type of diffuse large B-cell lymphoma, with characteristic clinico-epidemiological, immunohistological, and biological features.
Androulaki
A
A
Department of Pathology, Laiko General Hospital, Medical School, University of Athens, Athens, Greece.
Drakos
E
E
Hatzianastassiou
D
D
Vgenopoulou
S
S
Gazouli
M
M
Korkolopoulou
P
P
Patsouris
E
E
Dosios
T
T
D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D016724:Empyema, Pleural / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000473:pathology; D017809:Fatal Outcome; D006115:Greece; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D016393:Lymphoma, B-Cell / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D008297:Male; D010997:Pleural Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D012367:RNA, Viral / Q000032:analysis; D019043:Vascular Neoplasms / Q000473:pathology
D014408:Biomarkers, Tumor; D012367:RNA, Viral