Clinical features:
(1) older adult with chronic pyothorax for many (> 20) years
(2) comorbidities are common
(3) chest and/or back pain
(4) fever
(5) swelling in the chest wall
(6) productive cough, dyspnea, hemoptysis or other respiratory symptoms
Many cases are associated with pulmonary tuberculosis, with or without artificial pneumothorax.
Pathologic features:
(1) usually a diffuse large B-cell lymphoma (DLBCL) with occasional peripheral T-cell lymphoma or other types
(2) Epstein-Barr virus (EBV) can be demonstrated in the tumor cells of DLBCL
(3) The lymphoma may involve regional lymph nodes and/or other organs.
Poor prognostic factors:
(1) Stage III or IV
(2) poor performance status (ECOG 2 to 4)
(3) renal failure
(4) other serious comorbidities
(5) elevated (non-normal) serum LDH
(6) poor response to therapy (surgery and/or chemoradiation)
(7) male gender
