Pyothorax-associated lymphoma: a case showing transition from T-cell-rich polymorphic lesion to diffuse large B-cell lymphoma.
Pyothorax-associated lymphoma was found in a man who had a history of collapse therapy for pulmonary tuberculosis about 50 years ago. An autopsy specimen revealed histology of diffuse large B-cell lymphoma with latency III Epstein-Barr virus (EBV) infection. However, an open biopsy 2 years and 7 months before death showed a polymorphic appearance with abundant T-lymphocytes. Most of the EBV-infected atypical lymphocytes did not express either B- or T-cell markers as far as examined in the paraffin-embedded biopsy specimen, and rearrangements of immunoglobulin and T-cell receptors were not found. It seemed difficult to diagnose a B-cell lymphoma at the time of biopsy. However, retrospectively considered, if a phenotype of EBV-infected atypical lymphocytes is uncertain in cases showing polymorphic appearance, it might be better to consider the future evolution to overt B-cell lymphoma. Since pyothorax-associated lymphoma shows latency III infection of EBV, at least the immunohistochemistry of EBNA-2 and LMP-1 seems helpful for the diagnosis to prove which cells are infected by EBV.
Department of Pathology, Tokyo Women's Medical University, Tokyo, Japan. sheto@research.twmu.ac.jp
Tomoko
T
Yamamoto
Akihiro
A
Masuda
Tatsuo
T
Sawada
Toshio
T
Nishikawa
Kentaro
K
Yoshinaga
Hiroshi
H
Kazama
Toshiko
T
Motoji
Naoya
N
Nakamura
Makio
M
Kobayashi
D000368:Aged; D016724:Empyema, Pleural / Q000150:complications* / Q000473:pathology; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000473:pathology* / Q000821:virology; D008297:Male; D010997:Pleural Neoplasms / Q000150:complications / Q000473:pathology* / Q000821:virology; D011030:Pneumothorax; D016133:Polymerase Chain Reaction; D013601:T-Lymphocytes; D014397:Tuberculosis, Pulmonary / Q000150:complications