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Japanese Journal of Clinical Oncology 33:145-147 (2003)
© 2003 Foundation for Promotion of Cancer Research

Pyothorax-associated T-cell Lymphoma: a Case Report

Toshihiko Hashizume1, Katsuyuki Aozasa2, Yasuhiko Tomita2 and Kazuhiko Matsushita3,+,§

Departments of 1 Internal Medicine and 3 Pathology, Yokohama Sakaekyosai Hospital, Yokohama and 2 Department of Pathology, Osaka University Medical School, Osaka, Japan

We present a case of pyothorax-associated T-cell lymphoma in which Epstein–Barr virus (EBV) genome is not detected in the tumor cells. An 80-year-old male came to our hospital because of a left chest pain. Chest computed tomography (CT) showed a mass at the lower-dorsal part of the pyothorax wall, which involved the adjacent chest wall. The surgical biopsy specimen showed a predominant infiltration of atypical lymphocytes. Results of immunohistochemical analysis were as follows: CD3+, CD4–, CD8+, CD20–, CD30–, CD45RO+ and CD79a–. We diagnosed this case as a type of peripheral T-cell lymphoma. In situ hybridization using EBV-encoded RNA-1 (EBER-1) did not reveal the positive signals in the nucleus of tumor cells. Polymerase chain reaction (PCR) analysis yielded a negative result for human herpesvirus 8 (HHV8). Radiation therapy at 54 Gy reduced the tumor size by 90%. Visual and hearing disturbances of unknown etiology developed just before the completion of radiotherapy. The symptoms progressively worsened and the patient became bedridden. He died of pneumonia 2 months after the completion of radiotherapy. Autopsy did not reveal abnormalities to which the neurological disturbances were attributable.

+ For reprints and all correspondence: Toshihiko Hashizume, present address Miura City Municipal Hospital, 4–33 Koyo-Cho, Miura-City, Kanagawa 238-0222, Japan. E-mail: toshi{at}yk9.so-net.ne.jp

§ This report is attributed to Department of Internal Medicine, Yokohama Sakaekyosai Hospital


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