Pyothorax-associated lymphoma (PAL) is a rare form of non-Hodgkins lymphoma that has been described most often in Japan.
Clinical features:
(1) long-term history of chronic pyothorax or tuberculous pleuritis (>= 20 years)
(2) fever
(3) chest pain
(4) shortness of breath
(5) weight loss
where:
• In the past an artificial pneumothorax was used to treat pulmonary tuberculosis. Pyothorax sometimes developed as a complication of the procedure.
Pathologic features:
(1) There is a pleural thickening secondary to a lymphoproliferative disorder with or without extension into adjacent structures.
(2) The tumor is typically a diffuse large B-cell lymphoma (DLBCL) often with plasmacytoid features.
(3) Many tumor cells show in situ hybridization with Epstein-Barr virus (EBV).
(4) Tumor cells are negative for HHV-8.
(5) Tumor cells may show aberrant expression of T-cell markers.
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Specialty: Hematology Oncology