Pleural-origin malignant lymphoma in an elderly patient with chronic empyema and infection with the Epstein-Barr virus

Abstract

A 73-year-old woman with a long-standing history of right-sided chronic empyema complained of lumbago. An artificial pneumothorax had been induced to treat pulmonary tuberculosis about 40 years previously. The year after she began to complain of lumbago, a tumor mass over the right anterior chest wall had grown rapidly. Pathologic examination revealed that it was a malignant lymphoma (Non-Hodgkin's lymphoma, diffuse large cell, B cell type). Chemotherapy with cyclophosphamide, adriamycin, vincristine, and prednisolone, and then radiation therapy were given. The patient responded very well. The tumor mass on the surface of the chest wall disappeared completely. She was alive and well and there was no evidence of recurrence at the seven-month follow-up examination. Analysis with the polymerase chain reaction showed that the tumor contained DNA of the Epstein-Barr virus. The chronic empyema and local infection with the Epstein-Barr virus might have been a factor in the development of the malignant lymphoma.