A CASE OF MALIGNANT LYMPHOMA OF CHEST WALL COMBINED WITH CHRONIC EMPYEMATHORAX

It has increased that we encounter reports concerning a malignant lymphoma which appeared in the chest wall several decades after tuberculous empyemathorax or tuberculous pleuritis. A 54-year-old male, with asymptomatic chronic empyema thorax was admitted to the hospital because of pain from a huge chest tumor. The chest CT and MRI studies revealed that the tumor of the chest wall invaded the ribs, and it seems to arise from the chest wall which adjoined to the peel of the parietal pleura with severe carcifications of the empyemathorax. Biopsy of the tumor revealed a non-epitherial malignant tumor but correct diagnosis of a malignant lymphoma could not be attained. The tumor of the chest wall was widely resected and a radical surgery was also performed for chronic empyemathorax. The resected specimens were pathologically diagnosed as non-Hodgikin's malignant lymphoma which was of B cell lymphocyte origin, diffuse type and medium sized cell type by LSG classification. Two courses of chemotherapy with ACOP were administered after the surgery. There has been no sign of local recurrences and metastasis up to now. We discussed and reviewed this unusual cases which have been previously published in the Japanese literature.