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



• 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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